喉罩置入与气管插管对高血压病人心血管反应的比较  

Comparative study of hemodynamic responses to endotracheal intubation and laryngeal mask airway insertion

作　　者：马汉祥[1] 杨晨[2] 马富强[1] 刘红[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004 [2]宁夏银川市第一人民医院,宁夏银川750001

出　　处：《宁夏医学杂志》2006年第12期896-897,共2页Ningxia Medical Journal

摘　　要：目的观察和比较喉罩置入与气管插管对高血压病人心血管反应的影响。方法42例42-74岁,ASA分级Ⅱ-Ⅲ伴有高血压病史的择期手术患者,随机分为喉罩置入组(Ⅰ组,n=21)和气管插管组(Ⅱ组,n=21)。两组均采用瑞芬太尼-丙泊酚静脉复合麻醉,监测并记录基础值、插管前、插管后即刻、插管后1分钟、3分钟和5分钟各时点的平均动脉压(MAP)、心率(HR)及脑电双频谱指数(BIS)值。结果两组间BIS对应值无显著性差异(P>0.05);与喉罩置入组相比,气管插管组插管后即刻MAP和HR较明显升高和加快(P<0.05);组内与插管前相比,气管插管组插管后即刻MAP和HR明显升高和加快(P<0.01)。结论喉罩置入时引起心血管反应较气管导管插入时轻微,喉罩通气是高血压患者可供选择的通气方式之一。Objective To observe the effects on hemodynamic responses to endotracheal intubation and laryngeal mask airway insertion in hypertensive patients. Methods Forty two patients aged between 42 to 74 years old, ASA physical status Ⅱ-Ⅲ, were randomly allocated to either endotracheal intubation or laryngeal mask airway insertion groups. All patients were anesthetized by infusing remifentanil - propofol, BIS, MAP and HR value of baseine, before and after intubation, and every minute for the first 5 minutes after intubation were recorded. Results The BIS values were no significance between two groups （ P 〉0.05）. MAP and HR were significantly increased after intubation in endotracheal intubation group （ P 〈 0.01）. MAP and HR were significantly higher in endotracheal intubation group than those in laryngeal mask airway insertion group after intubation （ P 〈 0.01）. Conclusion Hemodynamic responses to endotracheal intubation were lower than those to laryngeal mask airway insertion. Laryngeal mask airway might be one of the best ventilation for hypertensive patients under anesthesia.

关 键 词：喉罩 气管插管 高血压 心血管反应 

分 类 号：R544.1[医药卫生—心血管疾病]