视频鼻镜与2级和3级肥胖症的直接鼻镜:随机对照试验的系统审查,元分析和试验顺序分析
Zhi Jie Goh1, Aaron Ang1, Si-Xian Nicole Ang1
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Anaesthesia
|April 8, 2025
概括
视频喉腔镜显著减少了肥胖患者 (BMI ≥35 kg/m2) 的气管管道输管失败和低氧症. 与直接喉腔镜相比,这种方法在这个高风险群体中提供了更好的结果.
科学领域:
- 麻醉学和重症监护医学
- 航线管理是指空中航道管理.
- 肥胖药物 肥胖药物 肥胖药物
背景情况:
- 气管管道输管率上升,部分原因是肥胖患病率增加.
- 患有2级或3级肥胖症 (BMI ≥35 kg/m2) 的患者会出现不成比例的高呼吸道和呼吸道并发症.
- 在肥胖患者中评估先进的呼吸道技术的需要至关重要.
研究的目的:
- 系统地比较视频喉科镜与直接喉科镜,用于2级或3级肥胖患者的气管输管.
- 评估视频喉腔镜对这一特定患者群体关键输管相关结果的影响.
主要方法:
- 在过去15年内发表的随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了五个数据库,对视频喉腔镜和直接喉腔镜进行比较的RCT,用于接受选择性手术的2或3级肥胖症成人患者.
- 主要结局包括输管失败,低氧症和第一次输管失败;次要结局评估了喉可视化,输管时间,喉疼痛和难度.
主要成果:
- 包括10项试验,955名患者 (481名视频喉科,474名直接喉科).
- 视频喉科显著减少了气管管道输入失败 (RR 0.15,p<0.001),低氧化 (RR 0.21,p<0.001) 和第一次尝试失败 (RR 0.44,p=0.004).
- 通过视频喉科镜检测观察到更好的喉视觉化;在输管时间,喉疼痛或难度等级上没有显著差异.
结论:
- 视频喉科显著降低了输管失败,第一次尝试失败,低氧化,并改善了患有2或3级肥胖症的患者的喉视觉.
- 患有2级或3级肥胖症的患者可能会从视频喉腔镜检查中获益,而不是从直接喉腔镜检查中获益.
- 支持在肥胖患者的呼吸道管理中采用视频喉腔镜.
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