帝视内镜与直接喉镜对患者气管插管血流动力学影响的比较  

The clinic observation of endotracheal intubation with discope intubating device versus macintosh direct laryngoscope in general anesthesia patients

作　　者：王晓亮[1] 鲍红光[1] 赵倩[1] 徐丽[1] 

机构地区：[1]南京医科大学附属南京第一医院麻醉科,210006

出　　处：《中华临床医师杂志（电子版）》2012年第4期I0015-I0017,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的观察帝视内镜与直接喉镜气管内插管时对患者血流动力学的影响。方法非心肺疾病及困难气道择期手术患者80例,随机分为帝视内镜组(DISCOPO组)和直接喉镜组(MDLS组),每组40例。记录麻醉前基础值(T1)、麻醉诱导后插管前(T2)、插管成功即刻(T3)及插管后1 min(T4)、5 min(T5)的SBP、DBP、MAP、HR、气管插管操作时间,计算心率收缩压乘积(RPP)。结果两组均顺利完成气管内插管。组内比较,DISCOPO组内,与T1时比较,T2时MAP和RPP都明显降低,差异有统计学意义(P<0.05);T3和T4时的MAP和RPP升高,但差异无统计学意义(P>0.05);而HR指标比较,差异均无统计学意义(P>0.05)。MDLS组内,与T1时比较,T2时MAP和RPP都明显降低,差异有统计学意义(P<0.05);T3和T4时的MAP、RPP和HR显著升高(P<0.05)。两组间比较,T3、T4时,MDLS组MAP、HR、RPP指标明显高于DIS-COPO组,差异有统计学意义(P<0.05)。结论帝视内镜、直接喉镜气管插管对血流动力学均有影响,帝视内镜气管插管反应较轻。Objective To investigate the hemodynamic responses to endotracheal intubation with discope intubating device versus macintosh direct laryngoscope（MDLS）in general anesthesia patients.Methods Eighty adult patients without difficult airways or cardiopulmonary diseases and scheduled for time-selective surgery under general anesthesia were randomly assigned to one of two groups（n=40 for each）.The discope group received tracheal intubation with discope,while the MDLS group with macintosh direct laryngoscope.Changes in systolic blood pressure（SBP）,diastolic blood pressure（DBP）,mean airway pressure（MAP）,heart rate（HR）and tracheal intubation time were measured before anesthesia induction（T1）,after anesthesia induction（T2）,immediately after intubation（T3）,1 minute after intubation（T4）and 5 minutes after intubation（T5）.Rate pressure product（RPP）were calculated.Results All procedures were successful on the first attempt.Compared with pre-induction（T1）,MAP and RPP in both two groups significantly decreased after anesthetic induction（P0.05）.However,compared with T1,MAP and RPP did not increase significantly（P0.05）at T3 and T4 in discope group,while MAP,RPP and HR did increase significantly（P0.05）at T3 and T4 in MDLS group.The HR at T1,T2,T3,T4 and T5 in discope group did not change remarkably（P0.05）.In MDLS group,MAP,HR and RPP at T3 and T4 were significant higher than those in scope group（P0.05）.Conclusions In comparison to Macintosh direct laryngoscope,tracheal intubation with discope laryngoscope resulted in less alterations in hemodynamic responses.

关 键 词：内窥镜 喉镜 插管法 气管内 血流动力学 

分 类 号：R614[医药卫生—麻醉学]