健忘镇痛慢诱导气管插管对梗阻性黄疸患者麻醉诱导期血流动力学的影响  

Influence of amnesic and analgesic slow induction tracheal intubation on hemodynamics of patients with obstructive jaundice in anesthesia induction period

作　　者：陈英强 

机构地区：[1]浙江省东阳市横店集团医院麻醉科,浙江东阳322118

出　　处：《中国现代医生》2015年第26期103-105,共3页China Modern Doctor

基　　金：浙江省医学会临床科研基金项目(2012ZYC-A88)

摘　　要：目的观察在梗阻性黄疸患者麻醉诱导期应用健忘镇痛慢诱导气管插管法对其血流动力学的影响,为提高该类患者的围麻醉期麻醉管理质量提供指导。方法对我院2013年1月~2014年7月收治的100例梗阻性黄疸患者均择期进行开腹手术,按照随机数字表方法分成对照组与观察组,每组各50例,分别给予常规快诱导插管与健忘镇痛慢诱导气管插管,对比两组患者诱导前后的血流动力学改变情况。结果观察组在诱导前、插管前、插管即刻及插管后3 min的血氧饱和度（Sp O2）、心率（HR）、平均动脉压（MAP）比较,差异均无统计学意义（P〉0.05）,而对照组插管后3 min的HR、MAP、Sp O2与诱导前均发生显著变化,差异均有统计学意义（P〈0.05）;观察组使用麻黄碱及使用麻黄碱次数〉2次的比率等均显著低于对照组,差异有统计学意义（P〈0.05）。结论健忘镇痛慢诱导气管插管可有效缓解梗阻性黄疸患者麻醉诱导期的应激反应,减轻对血流动力学的影响,值得广泛推广。Objective To observe the influence of amnesic and analgesic slow induction tracheal intubation on the hemodynamics of patients with obstructive jaundice in the anesthesia induction period in order to provide guidance for improving the patients＇ perianesthesic anesthesia management quality. Methods One hundred patients with obstructive jaundice treated in our hospital from January 2013 to July 2014 received selective laparotomy. The patients were divided into the control group and the observation group according to the random number table method, with 50 patients in each group, and were given conventional rapid induction intubation and amnesic and analgesic slow induction tracheal intubation. The hemodynamic changes of both groups before and after induction were compared. Results In the observation group, indicators including oxygen saturation （SpO2）, heart rate（HR） and mean arterial pressure（MAP） before induction, before intubation, immediately after intubation and 3 minutes after intubation had no statistically significant differences （P〉0.05）, but in the control group, indicators including HR and MAP, SpO2 after intubation 3 minutes changed significantly compared to those before induction, with statistically significant differences（P〈0.05）. The proportion of using ephedrine and the proportion of using ephedrine more than twice of the observation group were significantly lower than those of the control group, with statistically significant differences （P〈0.05）. Conclusion Amnesic and anal- gesic slow induction tracheal intubation can effectively relieve the stress reaction of patients with obstructive jaundice in the anesthesia induction period and alleviate the influence on hemodynamics, thereby worthy of wide promotion.

关 键 词：梗阻性黄疸 麻醉 健忘镇痛慢诱导气管插管 血流动力学 

分 类 号：R614.24[医药卫生—麻醉学]