Airtraq~视频喉镜、UE视频喉镜与Macintosh直接喉镜应用于老年非困难气管插管患者血流动力学的比较  

Comparison on hemodynamic responses of Airtraq~ videolaryngoscope,UE videolaryngoscope and Macintosh laryngoscope orotracheal intubation in elderly patients without difficult intubation

作　　者：王伟华[1] 马丽[1] 李善毅 

机构地区：[1]大连市第二人民医院麻醉科,辽宁大连116011

出　　处：《中国当代医药》2016年第26期93-96,共4页China Modern Medicine

摘　　要：目的比较Airtraq视频喉镜、UE视频喉镜和Macintosh直接喉镜应用于老年非困难气管插管患者的血流动力学差异。方法选择2015年8月~2016年5月我院60例老年患者,按随机数字表法将其分为UE视频喉镜组（U组）、Airtraq视频喉镜组（A组）和Macintosh直接喉镜组（M组）,每组20例。麻醉诱导后分别使用三种喉镜进行气管插管,记录显露声门时间,置入导管时间,麻醉诱导前（T_0）,气管插管前（T_1）,气管插管时（T_2）,插管后1 min（T_3）、3 min（T_4）、5 min（T_5）的收缩压（SBP）、舒张压（DBP）、心率（HR）数值,计算插管总时间及各观察点的二重指数（RPP）。结果 A组声门显露时间最长,导管置入时间最短,与U组和M组比较,差异有统计学意义（P〈0.05）,三组总插管时间比较差异无统计学意义（P〉0.05）。与T_0时点比较,三组T_1时SBP、DBP、RPP均明显下降,差异有统计学意义（P〈0.05）,HR变化不明显,差异无统计学意义（P〉0.05）;与T_1时点比较,A组T_2及T_3时SBP、DBP、RPP升高,差异有统计学意义（P〈0.05）,M组和U组T_5时HR、RPP,T_2、T_3和T_4时SBP、DBP、HR和RPP显著增高（P〈0.05）。组间比较：T_2、T_3和T_4时U组、M组SBP、DBP、HR、RPP显著高于A组,差异有统计学意义（P〈0.05）;T_5时M组HR、RPP高于A组、U组,差异有统计学意义（P〈0.05）。结论在老年非困难患者气管插管中,应用Macintosh直接喉镜和UE视频喉镜的血流动力学反应明显大于Airtraq视频喉镜。Objective To compare the hemodynamic responses of Airtraqvideolaryngoscope,UE videolaryngoscope and Macintosh laryngoscope in elderly patients without difficult intubation.Methods 60 elderly patients scheduled for surygery under general anesthesia requiring orotracheal intubation from August 2015 to May 2016 were randomly allocated to three group.After intravenous anesthetic induction,orotracheal intubation was performed with Airtraqvideolaryngoscope,UE videolaryngoscope or Macintosh laryngoscope.Parameters records included glottic exposure time,tracheal intubation time and noninvasive heart rate（HR）,systolic blood pressure（SBP） and diastolic blood pressure（DBP）before（T_0） and after anesthetic induction（T_1）,0 min（T_2）,1 min（T_3）,3 min（T_4）,5 min（T_5） after intubation.Rate-pressure product（RPP） and the total time of intubation were calculated.Results The glottic exposure time in group A was significantly longer than that in group M and group U（P〈0.05）,while the tracheal intubation time in group A was significantly shorter than that in group M and group U（P〈0.05）.The total time of intubation was no statistically significant difference（P〉0.05）.Compared with T_0,the SBP,DBP and RPP of three groups at T_1 decreased significantly（P〈0.05）,but the HR didn′t change remarkably.Compared with T_1,SBP,DBP and RPP at T_2,T_3 in group A increased significantly（P〈0.05）.In group M and group U,HR, RPP at T_5,SBP,DBP,HRand RPP at T_2,T_3 and T_4increased significantly compared with T_1（P〈0.05）.In group M and group U,HRand RPP at T_5,SBP,DBP,HRand RPP at T_2,T_3 and T_4were significant higher than those in group A.Conclusion In comparison to the UE videolaryngoscope and Macintosh laryngoscope,tracheal intubation with the Airtraqvideolaryngoscope resulted in less alterations in hemodynamic responses in elderly patients without difficult intubation.

关 键 词：Airtraq视频喉镜 UE视频喉镜 MACINTOSH直接喉镜 气管插管 血流动力学反应 老年患者 

分 类 号：R61[医药卫生—外科学]