可视化喉镜在困难气道管理中的临床应用及对血流动力学影响的对比分析
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于迪，张雨飞
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1.湖北省第三人民医院，湖北武汉，430000；2.华中科技大学同济医学院附属协和医院，湖北武汉，430022
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摘要：目的? 本研究旨在探讨可视化喉镜在困难气道管理中的临床效果及其对患者血流动力学的影响。方法? 采用前瞻性随机对照研究，将2023年1月至2024年12月于我院接受气管插管的120例困难气道患者随机分为传统喉镜组（A组，60例）与可视化喉镜组（B组，60例）。对比两组气道暴露分级、插管时间、首次插管成功率及插管前后不同时间点（T0：插管前、T1：插管即刻、T2：插管后5分钟、T3：插管后10分钟）的血流动力学指标（心率、收缩压、舒张压）。结果? B组气道暴露分级Ⅰ~Ⅱ级占比显著高于A组（P<0.05），插管时间短于A组（P<0.05），首次插管成功率显著高于A组（P<0.05）。血流动力学方面，B组插管即刻（T1）心率、收缩压、舒张压波动幅度显著小于A组（P<0.05），且术后并发症发生率更低（P<0.05）。结论? 可视化喉镜在困难气道管理中可显著改善气道暴露效果，提升插管效率及安全性，且对血流动力学影响更小，具有较高的临床应用价值。
关健词：可视化；喉镜；困难；气道管理；血流；动力学；气管插管
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Clinical application of visual laryngoscope in difffcult airway management and comparative analysis of its effects on hemodynamics
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Di Yu,Yufei Zhang
1.Hubei Provincial Third People's Hospital，Wuhan Hubei 430000，China； 2.Union Hospital, Tongji Medical College, Huazhong University of Science and Technology， Wuhan Hubei 430022，China
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Abstract：Objective This study aimed to explore the clinical effects of video laryngoscope in the management of difficult airway and its on patients’ hemodynamics. Methods A prospective randomized controlled study was conducted on 120 patients with difficult airway who underwent endotracheal intubation our hospital from January 2023 to December 2024. They were randomly divided into the traditional laryngoscope group (Group A, 60) and the video laryngoscope group (Group B, 60 cases). The grading of airway exposure, intubation time, first intubation success, and hemodynamic indicators (heart rate, systolic blood pressure, and diastolic blood pressure) at different time points (T0: before intubation, T: immediately after intubation, T2: 5 minutes after intubation, T3: 10 minutes after intubation) before and after intubation compared between the two groups. Results The proportion of grade I and II airway exposure in Group B was significantly higher than that in Group A (P < 0.05), the intubation time was shorter than that in Group A ( P < 0.05), and the ffrst intubation success rate was higher than that in Group A (P < 0.05). In terms of hemodynamics the ffuctuations of heart rate, systolic blood pressure, and diastolic blood pressure in Group B were significantly smaller than those in Group A at the moment of intubationT1) (P < 0.05), and the incidence of postoperative complications was lower ( P < 0.05). Conclusion Video laryngoscope can significantly improve the effect of airway exposure in the management of difficult airway,and increase the and safety of intubation, with less impact on hemodynamics, which has high clinical application value.
Keywords : Visualization; Laryngoscope; Difffculty; Airway management; Hemodynamic; Endotracheal intubation
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