广州医药 ›› 2023, Vol. 54 ›› Issue (3): 62-66.DOI: 10.3969/j.issn.1000-8535.2023.03.012

• 论著 • 上一篇    下一篇

视频喉镜下经食道超声探头插入在急诊重症患者中的应用

阳文杰1, 周丽芝2, 毕继伟1, 王萍1, 黄强1   

  1. 1 南方科技大学第一附属医院/暨南大学第二临床医学院,深圳市人民医院麻醉科(深圳 518020)
    2 南方科技大学第一附属医院/暨南大学第二临床医学院,深圳市人民医院疼痛科(深圳 518020)
  • 收稿日期:2022-05-08 出版日期:2023-03-20 发布日期:2023-04-14

Application of video laryngoscope assisted transesophageal echocardiography probe insertion in acute severe patients

YANG Wenjie1, ZHOU Lizhi2, BI Jiwei1, WANG Ping1, HUANG Qiang1   

  1. 1 Department of Anesthesia,Shenzhen People's Hospital(the First Affiliated Hospital of Southern University of Science and Technology/the Second Clinical Medical College of Jinan University), Shenzhen 518020,China
    2 Department of Pain Medicine, Shenzhen People's Hospital(the First Affiliated Hospital of Southern University of Science and Technology/the Second Clinical Medical College of Jinan University), Shenzhen 518020,China
  • Received:2022-05-08 Online:2023-03-20 Published:2023-04-14

摘要: 目的 探索视频喉镜下经食道超声(TEE)探头插入在急诊重症患者中的应用。方法 全麻下行非心脏手术的急诊重症患者60名,美国麻醉医师协会分级Ⅱ-Ⅳ级,采用随机数字法分成A组(n=30)和B组(n=30)2组。A组采用盲法插入TEE探头,B组采用视频喉镜辅助插入TEE探头。比较2组探头一次插入成功率、插入所需时间、插入时血流动力学变化、插入时不良反应的情况。结果 B组一次插入成功率(82.8%)高于A组(58.6%),差异有统计学意义(P<0.05)。B组第一次尝试成功插入所需时间长于A组,(24.6±3.1) s vs (15.5±3.0) s, 差异有统计学意义(P<0.05)。成功插入探头所需的总时间2组无差异,差异无统计学意义(P>0.05)。咽喉部损伤B组少于A组(3.4% vs 27.6%),差异有统计学意义(P<0.05)。探头插入时2组患者平均动脉压、心率无明显差异,差异无统计学意义(P>0.05)。结论 视频喉镜可以改善经食道超声探头插入的条件,提高插入成功率,减少相应并发症,可安全用于急诊重症患者的TEE探头插入。

关键词: 视频喉镜, 经食道超声, 急诊重症患者

Abstract: Objective To explore the application of transesophageal echocardiography (TEE) probe insertion under video laryngoscopy in acute severe patients. Methods Sixty acute severe patients, ASA grade II-IV, underwent non-cardiac surgery under general anesthesia were divided into two groups (A and B) evenly by random number method.TEE probe was blindly inserted into the group A patients, and in group B, a video laryngoscope was used to assist the insertion.The first insertion success rate, the time required for insertion, the changes of hemodynamics during insertion, and the adverse reactions incidence during insertion of the two groups were compared. Results The first insertion success rate of the group B (82.8%) was significantly higher than that of the group A (58.6%), the difference was statistically significant (P<0.05). The time required for the first successful insertion of the group B was significantly longer than that of the group A, (24.6±3.1) s vs (15.5±3.0) s, and the difference was statistically significant (P<0.05). The total time required to insert the probe was not significantly different between the two groups (P> 0.05). Throat injury in the group B was significantly less than that in the group A (3.4% vs 27.6%), the difference was statistically significant (P<0.05). The hemodynamics (MAP and HR) of the two groups during insertion were not significantly different (P>0.05). Conclusions Video laryngoscope can improve the conditions of transesophageal ultrasound probe insertion, increase the success rate of insertion, and reduce the corresponding complications.It can be safely used for TEE probe insertion in acute severe patients in an emergency.

Key words: video laryngoscope, transesophageal echocardiography, acute severe patients