帝视内镜与直接喉镜应用气管插管时血流动力学对比分析

Comparison of hemodynamics between tracheal intubation by disposcope and direct laryngoscope

目的比较帝视内镜与直接喉镜应用气管插管时对血流动力学的影响。方法选择2013年9月～2014年8月择期手术合并高血压患者80例,随机分为帝视内镜组（Ⅰ组）和直接喉镜组（Ⅱ组）,其中Ⅰ组采用帝视内镜引导下气管插管,Ⅱ组采用普通内镜引导下气管插管。观察记录两组麻醉诱导前（T0）、麻醉诱导后（T1）、插管成功瞬时（T2）、插管后1 min（T3）及插管后5 min（T4）的舒张压（DBP）、收缩压（SBP）、心率（HR）的变化。结果两组插管成功率均为100%,但Ⅰ组一次成功率显著高于Ⅱ组,而插管时间显著短于Ⅱ组（P〈0.05）;两组T1时的DBP、SBP和HR值均比同组T0时明显降低（P〈0.05）,而T2、T3和T4时的DBP、SBP和HR均比同组的T1时有明显上升（P〈0.05）,其中Ⅱ组T2和T3时的DBP、SBP和HR明显高于Ⅰ组（P〈0.05）。结论帝视内镜与直接喉镜气管插管均对高血压患者血流动力学有影响,但帝视内镜的影响较轻,对患者具有一定的保护作用。

Objective To make comparison between hemodynamic effects of disposcope and direct laryngoscope on patients during tracheal intubation. Methods 80 patients with complicated hypertension receiving selective operation between September 2013 and August 2014 were selected and randomly divided into disposcope group （group I ） and direct laryngoscope group （group Ⅱ）. Group I received disposcopic tracheal intubation, and group Ⅱ received endoscopic tracheal intubation. Observation and recording were made in the changes in diastolic blood pressure （DBP）, systolic blood pressure （SBP） and heart rate （HR） before anesthesia induction （T0）, after anesthesia induction （T1）, at the time of successful intubation （T2）, 1 min after the intubation （T3）, and 5 min after the intubation （T4）. B.etmlts The success rates of intubation in both groups were 100%. The one-time success rate of group 1 was significantly higher than that of group Ⅱ. The intubation time in group I was shorter than that in group II （P 〈 0.05）. The DBP, SBP, and HR values at TI time in the two groups significantly decreased compared with those values at TO （P 〈 0.05）. Those values at T2, T3, and T4 significantly increased than those at T1 in the same groups （P 〈 0.05）. The values at T2 and T3 in group Ⅱ were sifniciatnly higher than those in group I （P 〈 0.05）. Conclusion Disposcope and direct laryngoscope both have certain effects on the hemodynamics of hypertension patients during the tracheal intubation. However, disposcope has less effects and protective effect onpatients.