纤维支气管镜经口气管插管对老年高血压患者血管活性物质的影响  

Influence of orotracheal intubation with fiberbronchoscope on vasoactive substances in elderly patients with hypertension

作　　者：丁娴[1] 陈肖[1] 邹军[1] 

机构地区：[1]无锡市第三人民医院麻醉科,214041

出　　处：《临床麻醉学杂志》2011年第3期245-247,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨全身麻醉诱导后光导纤维支气管镜(FOB)经口气管插管对老年高血压患者血浆血管活性物质的影响。方法 32例ASAⅡ或Ⅲ级,高血压Ⅱ级,年龄≥60岁行择期胆囊切除术患者,随机均分为FOB组与直接喉镜组(LS组)。静脉诱导后分别行气管插管,并于麻醉诱导前(T1)、气管插管成功即刻(T2)及成功后5min(T3)监测血浆内皮素(ET)、血管紧张素Ⅱ(AngⅡ)及降钙素基因相关肽(CGRP)变化。结果 T2、T3时FOB组血浆ET、AngⅡ浓度明显低于LS组(P<0.05),而各时点两组CGRP组间差异均无统计学意义。结论 FOB经口气管插管对老年高血压患者血浆血管活性物质的浓度的影响较直接喉镜小。Objective To investigate the influence of orotracheal intubation with fiberbronchoscope after general anesthetic induction on vasoactive substances in elderly patients with hypertension. Methods Thirty-two patients aged 60y or over with ASA Ⅱ or Ⅲ and hypertension grade Ⅲ undergoing elective cholecystectomy were randomly allocated to either fiberbronchoscope （FOB） or laryngoscope （LS） group with 16 cases each. Intubation was performed after intravenous anesthetic induction, and the concentrations of endothelin （ET）, angiotensin Ⅱ （Ang Ⅱ ） and calcitoningenerelated peptide （CGRP） were measured before anesthesia induction （T1）, at the time of intubation immediately （T2） and 5 min after intubation （T3）, respectively. Results The plasma levels of ET and Ang Ⅱ were decreased significantly in the group FOB compared with the group LS at T2 and T3 （P 〈 0.05）, but no significant difference was observed in CGRP in both groups. Conclusion Orotracheal intubation with fiberbronchoscope can reduce the concentrations of the vasoactive substances in elderly patients with hypertension.

关 键 词：光导纤维支气管镜 血管活性物质 老年患者 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]