摘要
目的：比较帝视内镜（DISCOPO）、GlideScope视频喉镜与直接喉镜（Maciniosh direct laryngo-scope,DLS）经口气管插管时血流动力学反应。方法：择期行全身麻醉手术患者90例,ASA分级I或Ⅱ级,无困难气道,无心肺疾病,随机分为帝视内镜组（DS组）、GlideScope视频喉镜组（GS组）和直接喉镜组（DLS组）,每组30例。记录麻醉前基础值（T1）、麻醉诱导后（T2）、插管成功即刻（T3）及插管后1 min（T4）、3 min（T5）、5 min（T6）的SBP、MAP、HR、气管插管时间,计算心率收缩压乘积（RPP）。结果：3组均顺利完成气管内插管。各组诱导后T2时MAP、HR和RPP都较T1时显著降低（P〈0.05）,插管后T3、T4时的MAP、HR和RPP均较诱导后T2时显著升高（P〈0.05）。与T1比较,DS组T3~T6时差异无统计学意义。GS组、DLS组,与T1时比较,T3和T4时的MAP、RPP和HR显著升高（P〈0.05）,T5、T6时无统计学意义。组间比较,GS组与DLS组在各观察时点均无统计学差异,但T3、T4时,GS组、DLS组MAP、HR、RPP指标明显高于DS组,差异有统计学意义（P〈0.05）,T1、T2、T5和T6时与DS组比较无统计学差异。结论：3种方法经口气管插管对血流动力学均有影响,帝视内镜气管插管对血流动力学的影响较轻。
Objective： To investigate the hemodynamic responses to endotracheal intubation with discope, GlideScope intubation device versus macintosh direct laryngoscope （DLS） in general anesthesia patients. Methods： Ninety adult patients without difficult airways or cardiopulmonary diseases and scheduled for timeselective surgery under general anesthesia were randomly assigned to one of three groups （ n = 30 for each） . The DS group received tracheal intubation with discope , The GS group received tracheal intubation with GlideScope, while the DIS group with macintosh direct laryngoscope. Changes in Systolic pressure （SBP）, mean arterial pressure （MAP） , heart rate （HR） and tracheal intubation time were measured before anesthesia induction （T1）, after anesthesia induction（Tz）, immediately after intubation（T3 ） , 1 minute after intubation（T4）, 3 minutes after intubation（T5）, and 5 minutes after intubation（T6） , Rate - pressure product（RPP） were calculated. Results： All procedures were successful on the first attempt. Compared with preinduction （T1） , MAP,HR and RPP in all three groups significantly decreased after anesthetic induction（P 〈 0.05） . Compared with after anesthesia induction（Tz）, MAP, HR and RPP in all three groups significantly increased at Ta and T4 （P 〈 0.05）. However, compared with T1, MAP,HR and RPP did not increase significantly（P 〉0.05） at Ta,T4 in discope group, while MAP, HR and RPP did increase significantly（P 〈 0.05） at Ta and T4 in GS group and DLS between groups, there was no statistically significant difference between the observation point in GS group and DLS group. In GS and DLS group, MAP,HR and RPP at T3 and T4 were significant higher than those in discope group（P~ 0.05） . There was no statistically difference among three groups at Ta, T2, T5 and T6 （P 〉 0.05）. Conclusions： In comparison to DLS and GS, tracheal intubation with DS resulted in less alterations in hemodynamlc responses
出处
《内蒙古医学杂志》
2012年第11期1293-1296,共4页
Inner Mongolia Medical Journal
关键词
内窥镜
喉镜
插管法
气管
血流动力学
Endoscopes
Laryngoscopy
Tracjea
Int ubation
Hemodynamics
