目的 探讨通过透明的气管导管应用可视软镜观察SaCoVLM(safe comfortable video laryngeal mask)可视喉罩插入所造成咽喉部黏膜的即刻损伤情况,以评估此方法的可行性.方法 选取2021年2-8月中国医学科学院整形外科医院拟行外耳再造手术的小耳畸形患儿60例,经SaCoVLM可视喉罩进行气管插管后,将喉罩退出后,经透明的气管导管应用可视软镜观察喉罩置入过程对咽喉壁的即刻损伤情况.主要观察指标是喉罩位置分级、喉罩退出后喉罩带血情况及咽喉部黏膜损伤评分,次要指标包括喉罩的密封压、喉罩置入难易程度、喉罩放置时间、气管导管置入时间、喉罩退出时间以及气道并发症和咽喉部疼痛情况等,同时采用单因素logistic风险比例模型筛选与损伤可能相关的危险因素.结果 60例患儿全部完成SaCoVLM可视喉罩置入、气管插管和喉罩退出.喉罩退出后共有22例(36.7％)喉罩背面带有血迹,通过可视软镜观察咽喉部黏膜损伤0级24例(40.0％),1级19例(31.7％),2级3例(5.0％),3级14例(23.3％).术后随访共有20例患儿出现咽痛.采用单因素logistic风险比例模型分析结果显示,喉罩置入难易程度(P=0.048)、喉罩置入时间(P=0.045)及喉罩位置分级(P=0.050)是喉罩损伤相关的危险因素.结论 应用可视软镜通过透明的气管导管观察SaCoVLM可视喉罩置入过程引起咽喉部黏膜的即时损伤是可行的.

Objective To observe the feasibility and safety of intubation with Truview laryngoscope in the infants.Methods Sixty-two infants scheduled for selective plastic surgery under general anesthesia were randomly divided into 2 groups of T(Truview laryngoscope) and M(Macintosh laryngoscope) with 31 cases each. The view of glottic exposure were recorded.HR and SpO2 were recorded before and at intubation,1,2,3,4 and 5 min after intubation.The time for glottic exposure and intubation and complications during intubation were recorded as well.Results The view of glottic exposure of both groups was similar.The times for glottic exposure and intubation were longer in group T than those in group M(P0.05). There were no significant differences in HR and SpO2 between two groups.There were no significant complications related to intubation in two groups.Conclusion Compared to Macintosh laryngoscope,Truview is an effective intubation tool for infants with longer times for glottic exposure and intubation.

By directly binding to receptors on the ovary or through insulin like growth factor(IGF),growth hormone(GH) acts on the ovary.Basic medical researches demonstrated that GH can stimulate development and maturation of the follicles,increase the number of ovulation,even has some effects on synthesis of sexual hormone.Thereby,some scholars explored practical values of GH in human adjuvant ovulation stimulation,but the research results were controversial.Future studies should focus on improving regimen of GH in adjuvant ovulation stimulation.