经口盲探气管内插管的应用研究

Application of Blind Orotracheal Intubation

目的研究经口盲探气管插管方法对患者血流动力学及应激反应的影响。方法选择需全身麻醉手术患者50例,根据气管插管方法的不同,分为盲探组(T组)和喉镜组(C组),各25例,监测并记录入室(T0)、插管前(T1)、插管后3min(T2)、插管后60min(T3)2组患者平均动脉压(MAP)、心率(HR)的变化,并于T0、T3两时点测血糖(Glu)、血清皮质醇浓度(Cor),记录插管完成时间及次数,术后咽痛、声嘶等并发症。结果2组患者的MAP、HR在T2时点比较差异有统计学意义[(88.6±11.0)mmHg比(101.8±10.4)mmHg,t=4.383,P<0.01;(70.9±9.8)次·min-1比(79.7±14.4)次·min-1,t=2.539,P<0.05]。Glu、Cor在T3时点比较T组明显低于C组[(6.2±1.4)mmol·L-1比(7.5±1.3)mmol·L-1,t=3.359,P<0.01;(380.1±111.3)nmol·L-1比(450.8±129.5)nmol·L-1,t=2.071,P<0.05]。2组并发症无明显差别。结论盲探气管插管对患者的血流动力学及应激反应影响较小。

Objective To study the effect of blind orotracheal intubation on haemodynamics and stress reaction.Methods Fifty patients who required operation under general anesthesia were randomly divided into blind orotracheal intubation group （group T）and laryngoscopic tracheal in-tubation group （group C）,with 25 patients in each group.Mean arterial pressure （MAP）and heart rate （HR）were determined on admission to operating room （T0）,before intubation （T1）, at 3 minutes after intubation （T2）,and at 60 minutes after intubation （T3）.Furthermore,levels of blood glucose （Glu）and serum cortisol （Cor）were measured at T0 and T3.Moreover,time to intubation completion,frequency of intubation,and complications （pharyngalgia,hoarseness,etc.） were recorded in both groups.Results The MAP and HR in group T（（88.6±11.0）mmHg and （70.9 ± 9.8）beats· min-1 minutes,respectively）were markedly lower than those in group C （（101.8±10.4）mmHg and （79.7±14.4）beats·min-1 ,respectively）at T2 （P 〈0.05）.In addi-tion,levels of blood Glu and serum Cor in group T （（6.2 ± 1.4）mmol · L-1 and （380.1 ± 111.3）nmol·L-1 ,respectively）were significantly lower than those in group C （（7.5±1.3）mmol·L-1 and （450.8 ± 129.5）nmol· L-1 ,respectively）at T3 （P 〈 0.05）.No significant differences in complications were found between the two groups.Conclusion The blind orotracheal intubationhas little effect on haemodynamics and stress reaction.