急救中光棒法与直接喉镜法气管插管引发心血管反应的比较  

Comparison of the Cardiovascular Response between Lightwand and Direct Laryngoscope Tracheal Intubation in Emergency Treatment

作　　者：俞宁[1] 沈印[1] 龙胜规[1] 唐宇涛[1] 贾红轩[1] 

机构地区：[1]广西壮族自治区人民医院急诊科,广西南宁530021

出　　处：《现代生物医学进展》2012年第16期3163-3166,共4页Progress in Modern Biomedicine

摘　　要：目的:比较光棒法与直接喉镜法气管插管对心血管系统的影响,探讨光棒在临床急救领域的适用性。方法:选取我院急诊科室进行抢救的80名患者,随机分为两组,分别采用光棒法和直接喉镜法进行气管插管。记录插管所需时间、一次插管成功次数,以及插管前、插管时、插管后1分钟、插管后3分钟患者的收缩压、舒张压、平均动脉压、心率和血氧饱和度的变化情况。数据分析使用使用检验、t检验秩和检验、重复测量方差分析。结果:两组间性别、年龄、身高、体重、ASA、Mallampati评分差异无统计学意义,具备可比性。光棒组平均插管时间少于喉镜组(光棒:31.23 9.94秒,喉镜:48.15 8.67秒),一次插管成功率(97.5%)也高于喉镜组(80.0%)。经重复测量方差分析结果显示,光棒组各时点的收缩压(F=38.312,P=0.000)、舒张压(F=219.692,P=0.000)、平均动脉压(F=54.739,P=0.000)、心率(F=195.161,P=0.000)的整体趋势要低于与喉镜组。血氧饱和度(F=0.020,P=0.889)在两组间差异无统计学意义。结论:在气管插管过程中,光棒法比直接喉镜法引发的心血管系统变化更小,而且插管所需时间更短、一次成功率更高,是一种值得在急诊科室推广的气管插管技术。Objective： To study the feasibility of lightwand tracheal intubation in emergency process,compare the cardiovascular response between lightwand and direct laryngoscope tracheal intubation.Methods： 80 patients getting emergency treatment were randomly classified into lightwand or laryngoscope group.We recorded intubation time,success rate of first intubation,SBP,DBP,MAP,HR and SPO2 at period of ＂before intubation＂,＂during intubation＂,＂after intubation 1min ＂ and ＂after intubation 3mins＂ for 2 groups.Results： Contrast to laryngoscope,lightwand completed tracheal intubation with shorter time（lightwand： 31.23 9.94s,laryngoscope： 48.15 8.67s） and better success rate in the first intubation（lightwand： 97.5%,laryngoscope：80.0%）.The result of repeated measurement variance anal-ysis showed that the tendency of SBP,DBP,MAP and HR at different period was lower among lightwand group,compared with laryngo-scope group.Conclusion： During tracheal intubation process,contrast to laryngoscope tracheal intubation,lightwand induced less cardio-vascular response and were associated with better intubation time and success rate.Thus,it was a suitable technology to be used in Emer-gency setting.

关 键 词：光棒 喉镜 气管插管 心血管系统 

分 类 号：R459.7[医药卫生—急诊医学]