三种气管插管方式对血流动力学的影响

INFLUENCES OF THREE WAYS OF TRACHEAL INTUBATION ON HAEMODYNAMICS

目的:评价Macincosh直接喉镜、电子视频喉镜、4号喉罩三种气管插管方式在同等麻醉深度下(BIS=40)对病人血流动力学的影响。方法:60例非腹腔镜择期手术病人随机分为3组:Macincosh直接喉镜组(DL组)、电子视频喉镜组(VL组)、4号喉罩组(F4组),每组20例。记录3组病人麻醉前(T0)、诱导后(T1)、喉罩置入或插管即刻(T2)、插管后3min(T3)、插管后5min(T4)的收缩压(SBP)、舒张压(DBP)和心率(HR)。结果:三组病人T1时刻的SBP、DBP、HR明显低于麻醉前(P<0.05),T2时刻的SBP、DBP、HR明显高于麻醉前(P<0.05);T3、T4时刻的SBP、DBP、HR与麻醉前比较差异无统计学意义(P>0.05)。DL组、VL组、F4组病人T0、T1、T3、T4时刻SBP、DBP、HR比较,差异无统计学意义(P>0.05);T2时刻DL组病人的SBP、DBP、HR均明显高于VL组和F4组(P<0.05)。结论:电子视频喉镜、4号喉罩较Macincosh直接喉镜对血流动力学的影响小,适合于临床应用。

Objective： To evaluate the influences of three ways of tracheal intubalion, Macincosh direct laryngoscope, video laryngoscope and laryngeal mask （number 4） on haemodynamics under same anesthesia depth （BIS=40）. Methods： 60 cases non laparoscopic selective operation patients were randomly divided into 3 groups （n=20）： Macincosh direct laryngoscope （DL group）, video laryngoscope group （VL group） and laryngeal mask （number 4） group （F4 group）. The systolic blood pressure （SBP）, diastolic blood pressure （DBP） and heart rate （HR） of patients before anesthesia （T0）, after induction （TI）, at intubation （T2）, 3 minutes after intubation （T3） and 5 minutes after intubafion （T4） were recorded respectively. Results： The SBP, DBP and HR at T1 of patients in 3 groups were all obviously lower than that before anesthesia （P〈0.05）; The SBP, DBP and HR at T2 of patients in 3 groups were all obviously higher than that before anesthesia （P〈0.05）; Them was no statistically significant difference about SBP, DBP and HR at T3 and T4 compared with that before anesthesia （P〉0.05）. Them was no statistically significant difference about SBP, DBP and HR at T0, T1, T3, T4 between DL group, VL group and F4 group （P〉0.05）. At T2, The SBP, DBP and HR ofpatients in DL group were obviously higher than VL group and F4 group （P〈0.05）. Conclusions： Compared with direct laryngoscope, the influences of video laryngoscope and laryngeal mask on haemodynamics are small, which are suitable for clinical application.