不同插管方式对困难气管插管患者血流动力学的影响  

The effect of different intubation ways on the hemodynamics of patients wih difficult tracheal intubation

作　　者：韩杰[1] 李梅[1] 石军[1] 

机构地区：[1]安徽省淮南市第一人民医院麻醉科,232007

出　　处：《蚌埠医学院学报》2014年第6期732-734,共3页Journal of Bengbu Medical College

摘　　要：目的：探讨纤维支气管镜（ FOB）和Lightwand光棒在经口困难气管插管过程中对患者血流动力学的影响。方法：50例拟施气管插管全麻下行外科手术、术前访视评估确定为困难气道的患者，随机分为FOB组（ F组）和Lightwand光棒组（ L组）。观察和记录2组患者入手术室麻醉诱导前（ T0）、诱导后插管前（ T1）、气管插管即刻（ T2）、插管后1 min（ T3）、3 min（ T4）、5 min （ T5）的收缩压、舒张压、心率和脉搏血氧饱和度；记录气管插管总时间、插管成功例数及术后并发症情况。结果：F组和L组气管插管成功率分别为100.0%和92.0%，差异无统计学意义（P〉0.05）。术后声音嘶哑及咽痛的发生率差异均无统计学意义（P〉0.05）；F组插管总时间明显少于L组（P〈0.05）；T2、T3时F组舒张压及心率均低于L组（P〈0.05-P〈0.01）。结论：FOB比Lightwand光棒对患者血流动力学影响相对较小，二者均可作为解决困难气管插管的有效方法。Objective：To explore the effects of fiber bronchoscope（ FOB） and Lightwand wand on the hemodynamics of patients with difficult tracheal intubation through the mouth. Methods：Fifty patients with difficult airway treated with surgery through tracheal anesthesia were randomly divided into FOB group（F group） and Light wand group（L group）. The systolic pressure,diastolic blood pressure,heart rate, pulse oxygen saturation in two groups were observed before anesthesia induction （ T0 ） , before intubation （ T1 ） , endotracheal intubation （ T2 ） , and at 1 minute （ T3 ） , 3 minutes （ T4 ） and 5 minutes （ T5 ） after intubation, and the total time of endotracheal intubation, successful intubation cases and postoperative complications in two groups were recorded. Results：The endotracheal intubation success rate in F group and L group were 100. 0% and 92. 0%,respectively,the difference of which had no statistical significance（P＆gt;0. 05）. The differences of the incidences of postoperative voice hoarse and sore throat between two groups had no statistical significance（P＆gt;0. 05）. The total time of endotracheal intubation in F group was significantly less than that in L group （P〈0.05）,the DBP and HR value in F group were significantly lower than those in L group at T2 and T3（P〈0.05 to P〈0.01）. Conclusions：Compared with Lightwand,the effect of FOB on hemodynamics is smaller. Both FOB and Lightwand are effective methods to solve the difficult tracheal intubation.

关 键 词：插管法 气管内 纤维支气管镜 光棒 血流动力学 

分 类 号：R472.9[医药卫生—护理学]