HC可视喉镜在全身麻醉气管插管中的应用及对患者血流动力学和应激反应的影响  

Application of HC visual laryngoscope in general anesthesia for tracheal intubation and its influence on hemodynamics and stress response

作　　者：魏育洁[1] 宋俊岭[1] 刘焕瑛[1] Wei Yujie;Song Jurding;Liu Huanying(Zhengzhou Central Hospital,Zhengzhou 450007,Henan,China)

机构地区：[1]郑州市中心医院,河南郑州450007

出　　处：《临床心身疾病杂志》2019年第5期73-77,共5页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨HC可视喉镜在全身麻醉气管插管中的应用效果以及对患者血流动力学和应激反应的影响.方法将192例进行全身麻醉气管插管的患者按随机数字表法分为两组,每组96例,观察组采用HC可视喉镜,对照组采用普通喉镜,分别进行辅助下气管插管,比较两组气管插管效果、声门暴露程度、并发症发生率及插管前、插管即刻、插管后5min收缩压、舒张压、心律;检测两组血清去甲肾上腺素、肾上腺素、血清皮质醇水平变化.结果观察组声门暴露时间、插管时间均显著短于对照组(P<0.01),声门暴露、一次插管成功率均显著高于对照组(P<0.01);插管出血、牙齿脱落、咽部不适、声音嘶哑、口腔黏膜损伤发生率均显著低于对照组(P<0.01).插管即刻、插管后5 min两组血流动力学指标收缩压、舒张压、心律均较插管前显著升高(P<0.01),观察组各项指标水平均显著低于对照组(P<0.01);插管5 min后两组氧化应激指标去甲肾上腺素、肾上腺素、血清皮质醇水平均较插管前显著升高(P<0.01),观察组各项指标水平均显著低于对照组(P<0.01).结论应用HC可视喉镜行气管插管具有耗时短、提高声门暴露、一次插管成功率高、减少血流动力学变化及应激反应的发生、安全性高,显著优于传统喉镜下气管插管效果,值得临床推广应用.Objective To investigate the effect of HC visual laryngoscope in general anesthesia for tracheal intubation and its influence on hemodynamics and stress response. Methods 192 cases of patients with general anesthesia tracheal intubation were randomly classified into two groups, 96 cases in each group. The observation group used HC visual laryngoscope, and the control group used ordinary laryngoscope, two groups all given assisted intubation tracheal intubation. The effects of tracheal intubation, glottic ex-posure, and complication rate were compared between the two groups, as well as systolic blood pressure, diastolic blood pressure, and heart rate before intubation, immediately after intubation, and 5 min after in-tubation. Changes in serum norepinephrine,adrenaline,and serum cortisol levels were measured. Results The glottic exposure time and intubation time of the observation group were significantly shorter than the control group (P<0. 01). The glottic exposure and the success rate of one intubation were significant-ly higher than those of the control group (P< 0. 01). The incidence of intubation bleeding, tooth loss, pharyngeal discomfort, hoarseness and oral mucosal injury were significantly lower than those of the con-trol group (P< 0. 01). Immediately after intubation and 5 min after intubation, the systolic blood pres-sure, diastolic blood pressure and heart rhythm of the two groups were significantly higher than those be-fore intubation (P<0. 01). The average level of indicators in the observation group was significantly lower than that in the control group (P<10. 01). After 5 min of intubation,the levels of norepinephrine, adrenaline and serum cortisol weresignificantly higher than those before intubation (P<0. 01). The indica-tors of the observation group were significantly lower than those of the control group (P<0.01). Conclu-sions Application of HC visual laryngoscope for tracheal intubation has the advantages of short time-con-suming, improved glottic exposure, high success rate of one intubation

关 键 词：全身麻醉 HC可视喉镜 传统喉镜 气管插管 血流动力学 应激反应 声门暴露 一次插管成功率 并发症 

分 类 号：R614.2[医药卫生—麻醉学] R615[医药卫生—外科学]