正中入路优亿可视硬性喉镜辅助气管插管及教学的的体会.docVIP

正中入路优亿可视硬性喉镜辅助气管插管及教学的的体会 　　[摘要] 优亿可视硬性喉镜是在普通硬镜的基础上，增加了彩色的视频系统，在辅助气管内插管的同时提供清晰、连续及放大的呼吸道图像。在临床工作中，可视硬性喉镜不仅逐渐成为困难气道管理的利器，同时由于硬镜辅助气管内插管时对患者心血管系统干扰轻等优点，其在普通患者气管插管中也具有着明显的优势。可视硬性喉镜正中入路辅助气管内插管包括寻找会厌、绕会厌及置入气管导管三步。在临床工作及教学实践中，正中入路的标准化操作具有重复性好，好学易懂等特点，可以明显缩短学员使用可视硬性喉镜辅助气管内插管的学习曲线时间。优亿可视硬性喉镜及正中入路辅助气管内插管的方法值得在临床工作及教学中进行推广。 　　[关键词] 可视硬性喉镜；气管内插管；学习曲线；教学 　　[中图分类号] G645 [文献标识码] A [文章编号] 1673-7210（2016）04（a）-0127-05 　　[Abstract] UE Video assisted rigid laryngoscope which based on the traditional rigid laryngoscope， can assist to endotracheal intubation with a clear， continuous and magnified respiratory track figure through a video system. During clinical work， video assisted rigid laryngoscope helping endotracheal intubation is not only feasible to the difficulty airway treatment， but also feasible to the normal airway treatment because it has very slight disturbance on the cardiovascular system during intubation. Video assisted rigid laryngoscope midline approaching assisted endotracheal intubation includes three steps： finding the epiglottis， passing the epiglottis and endotracheal intubation. In clinical work and teaching practice， the standardized operation of middle approaching endotracheal intubation has the advantages of good repeatability and easy to understand and learn， and so that， this method can significantly shorten the time of learning curve of students learning how to use the video assisted rigid laryngoscope. The UE video assisted rigid laryngoscope and the middle approaching assisted endotracheal intubation are worthy to be popularized in clinical work and clinical training. 　　[Key words] Video assisted rigid laryngoscope； Endotracheal intubation； Learning curve； Training 　　随着可视技术的发展，可视插管器械在临床麻醉中也扮演着越来越重要的作用[1]。视可尼可视硬性喉镜作为一种困难气道的解决手段，经培训熟练掌握后可使气管内插管更易被操作，用时更短，插管成功率更高[2-3]，尤其是困难气道患者，应用视可尼可视喉镜辅助气管内插管有更高的成功率[4]。而且，视可尼可视喉镜辅助气管内插管较普通喉镜插管对患者的咽喉部损伤更小，对循环影响更轻[5-6]。通常视可尼可视喉镜辅助气管内插管方法包括正中入路，嘴角入路及观察光斑等方法[7-9]。但由于视可尼可视喉镜只能一个人操作，一般情况从接触开始到熟练操作视可尼可视喉镜辅助气管内插管需要一个较长的过程。