光棒与喉镜对气管插管血流动力学和应激反应的影响  

Effect of lightwand and normal laryngoscope on the hemodynamic and stress response to orotracheal intubation

作　　者：党旭云[1] 蔚俊星 李静[1] DANG Xuyun YU Junxing LI JING(Department of Anesthesiology, First Affiliated Hospital of Xi＇ an Medical University, Xi＇ an 710077, China Department of Anesthesiology, Forth Hospital of Xi ＇ an)

机构地区：[1]西安医学院第一附属医院麻醉科,西安710077 [2]西安市第四医院麻醉科

出　　处：《山西医科大学学报》2016年第9期867-869,共3页Journal of Shanxi Medical University

摘　　要：目的观察光棒与喉镜对气管插管血流动力学和应激反应的影响。方法择期非心脏手术患者60例,ASAⅠ-Ⅱ级,在全麻下行经口气管插管。随机分为光棒组和喉镜组,每组30例。监测麻醉诱导前(T1),插管即刻(T2),插管后1 min(T3),5 min(T4),10 min(T5)时的血压(BP)和心率(HR),并分别在T1、T5时刻采集肘静脉血测定皮质醇的浓度。结果与T1时刻相比,两组患者在T2、T3时刻的血压、心率均升高,且喉镜组升高均大于光棒组,组间差异有统计学意义(P<0.05)。T4、T5与T1时刻相比,变化幅度不大(P>0.05),且组间无统计学差异(P>0.05)。与T1相比,两组的皮质醇浓度在T5时刻均明显升高(P<0.01),且喉镜组高于光棒组(P<0.01)。结论与普通喉镜相比,采用光棒经口气管插管所导致的应激反应较小,血流动力学更平稳。Objective To explore the effect of lightwand and normal laryngoscope on the hemodynamics and stress response to orotracheal intubation. Methods Sixty patients scheduled for selected non-heart surgery under general anesthesia requiring orotracheal intubation were randomly allocated into lightwand group（ n = 30） and laryngoscope group（ n = 30）. The blood pressure and heart rate were recorded and analyzed before anesthetic induction（ T1）,at intubation（ T2）,1 min after intubation（ T3）,5 min after intubation（ T4） and 10 min after intubation（ T5）. The concentrations of cortisol in the vein were measured before anesthetic induction（ T1）,10 min after intubation（ T5）. Results Compared with T1,BP and HR were significantly increased in both groups at T2 and T3（ P〈0. 05）. At T2 and T3,compared with laryngoscope group,BP and HR increased in lightwand group（ P〈0. 05）. At T4 and T5,there was no significant difference in BP and HR between two groups（ P〈0. 05）. Compared with T1,the concentration of cortisol was significantly increased in both groups at T5（ P〈0. 01）,and there was significant difference between two groups（ P〈0. 01）. Conclusion Compared with normal laryngoscope,lightwand in orotracheal intubation is of great significance in terms of better hemodynamics and less stress response.

关 键 词：光棒 喉镜 气管插管 血流动力学 应激反应 

分 类 号：R614.2[医药卫生—麻醉学]