摘要
目的 探讨纤维支气管镜引导联合麻醉法在强直性脊柱炎(ankylosing spondylitis,AS)清醒气管插管患者中的应用效果。方法 选取2021年1月至2024年12月漳州第三医院收治的60例采取清醒气管插管进行手术的AS炎患者,以随机数表法作为分组依据,分为对照组(n=30,采用传统插管+麻醉);观察组(n=30,采用纤维支气管引导联合麻醉)。比较两组患者麻醉各时间段的心率(HR)、平均动脉压(MAP)和血氧饱和度(SpO_(2))以及插管时间、首次插管成功率;评估两组患者并发症发生率;对两组患者术后1d、5d、10d的咽痛(hrince-renry)评分和口腔舒适度评分进行比较。结果 两组患者插管T0、T1的HR、MAP、SpO_(2),及T2的SpO_(2)差异无统计学意义(P>0.05)。观察组在T2-T4时的HR、MAP显著低于对照组,且在T3-T4时的SpO_(2)显著高于对照组,差异均具有统计学意义(P<0.05)。观察组的首次插管成功率高于对照组,插管时间短于对照组,并发症发生率低于对照组,且术后Prince-Henry评分更低、口腔舒适度评分更高,差异均具有统计学意义(P<0.05)。结论 纤维支气管镜引导联合麻醉法对AS患者清醒气管插管患者效果较佳,能够降低应激反应,降低有关并发症发生率,提高首次插管成功率。
Objective To explore the application of fiberoptic bronchoscope guidance combined with anesthesia in awake endotracheal intubation for patients with ankylosing spondylitis(AS).Methods Sixty AS patients who underwent awake endotracheal intubation for surgery at the Third Hospital of Zhangzhou between January 2021 and December 2024 were enrolled.They were randomly assigned into two groups using a random number table method:the control group(n=30),which received traditional intubation and anesthesia,and the observation group(n=30),which received fiberoptic bronchoscope-guided intubation combined with anesthesia.Heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO_(2))at diff erent time points,intubation time,and first-pass success rate of intubation were compared between the two groups.The incidence of complications was also assessed,and the postoperative pain(prince-henry)and oral comfort scores on days 1,5,and 10 were compared.Results There were no statistically significant diff erences in HR,MAP,or SpO_(2) at T0 and T1,or in SpO_(2) at T2 between the two groups(P>0.05).However,significant diff erences in HR,MAP,and SpO_(2) were observed at T2-T4(P<0.05).The first-pass success rate of intubation,intubation time,complication rate,Prince-Henry pain scores,and oral comfort scores all showed significant diff erences between the two groups(P<0.05).Conclusion Fiberoptic bronchoscope guidance combined with anesthesia demonstrates a better effect in awake endotracheal intubation for AS patients.This method reduces stress responses,lowers the incidence of related complications,and improves the first-pass success rate of intubation.
作者
庄甲庚
柏发红
ZHUANG Jiageng;BAI Fahong(Department of Anesthesiology,Third Hospital of Zhangzhou,Zhangzhou 363005,China)
出处
《中华灾害救援医学》
2025年第5期560-563,共4页
Chinese Journal of Disaster Medicine
基金
中国管理科学研究教育科学研究所科教创新研究重点课题(KJCX14310)。
关键词
纤维支气管镜
麻醉法
强直性脊柱炎
Fiberoptic bronchoscope
Anesthesia
Lidocaine aerosol throat spray
