视频喉镜和头部可控气管导管经口气管插管对血流动力学的影响

Effect of orotracheal intubation with tracheal tube with controllable tip under Glidescope video laryngoscope on the hemodynamics

目的比较在视频喉镜下使用头部可控气管导管与普通气管导管经口气管插管对血流动力学的影响。方法择期外科手术患者160例，ASAI或Ⅱ级，随机分为两组：普通气管导管组（OT组）和视频喉镜下头部可控气管导管组（CT组），每组各80例。常规麻醉诱导后，在视频喉镜下，分别采用普通气管导管或头部可控气管导管实施经口气管插管，记录麻醉诱导前基础值（T1），气管插管前即刻（T2），气管插管后即刻（T3），以及插管后2min（T4）和5min（T5）的血压和心率，并记录气管插管时间。结果与气管插管前即刻相比，气管插管后即刻和插管后2min，OT组心率增快（P〈0．05）；与OT组相比，CT组插管时间明显缩短（P〈0．05）；气管插管后即刻和插管后2min，CT组心率减慢（P〈0．05）。结论与普通气管导管相比，在视频喉镜下，使用头部可控气管导管经口气管插管对血流动力学的影响小。

Objective To examine the hemodynamic changes when orotracheal intubation was performed by using tracheal tube with controllable tip or ordinary tracheal tube under Glideseope video laryngoscope. Methods one hundred and sixty patients （ ASA I or II ） scheduled for elective surgery were randomly divided into two groups（ n = 80 in each） ：OT group and CT group. After a routine anesthetic induction, orotracheal intubation was conducted by using tracheal tube with controllable tip or ordinary tracheal tube under Glideseope video laryngoscope. Blood pressure （BP） and heart rate （HR） were recorded before and 0,2 and 5 min after intubation as well as time spent for tracheal intubation. Results In the OT group, HR was increased significantly immediately after and 2 min after tracheal intubation when compared to that immediately before intubation （ P 〈 0.05 ）. Tracheal intubation time was significantly shorter in the CT group than in the OT group（ P 〈 0.05 ）. The HR in the CT group was significantly lower than in the OT group immediately after and 2 min after tracheal intubation（ P 〈 0.05 ）. Conclusion Under Glidescope vide laryngoscope, use of tracheal tube with controllable tip rather than ordinary tracheal tube causes little influence on the hemodynamics of patients given orotracheal intubation.