不同喉镜全麻气管插管时患者血流动力学的比较

目的比较可视喉镜与普通喉镜全麻下气管插管对非困难气道患者血流动力学变化的影响。方法ASA I～Ⅱ级拟行全麻下经口气管插管手术治疗的非困难气道患者120例，随机分为A组与B组，每组各60例，A组患者行可视喉镜全麻下气管插管，B组患者行普通喉镜全麻下气管插管，监测两组患者麻醉诱导前（TO）、气管插管时（T1）、插管后5min（T2）、插管后10min（T3）、插管后20min（T4）及插管后60min（T5）的血流动力学指标变化情况，在麻醉诱导前（T0）、插管后10min（T3）、插管后60rain（T5）抽取肘静脉血监测皮质醇浓度评估患者应激情况，观察两组患者气管插管时间及并发症发生情况。结果T2、T3时刻，A、B两纽患者BP、HR及RPP等血流动力学指标较插管前升高，差异有统计学意义（P〈0．05），A组BP、HR及RPP升高幅度与B组比较，差异有统计学意义（P〈0．05）；T3、T5时刻A、B两组患者皮质醇浓度显著升高，差异有统计学意义（P〈0．05），A组患者皮质醇浓度升高幅度低于B组，差异有统计学意义（P〈0．05）；A组患者并发症总发生数显著低于B组（3．3％vs13.3％），差异有统计学意义（P〈0．05）。结论可视喉镜可显著降低非困难气道患者血流动力学变化波动，减轻患者应激反应，减少并发症的发生情况，值得临床推广。

Objective To compare ordinary video laryngoscopes laryngoscope under the influence of general anesthesia endotracheal intubation on hemodynamies in patients with no difficult airway. Methods 120 cases ofASA I～Ⅱ level and undergoing non-difficult airway intubation under general anesthesia surgery were selected from October 2013 to October 2015 in our hospital and were randomly divided into group A, group B, 60 cases in each group. A group of patients underwent general anesthesia endotracheal intubation laryngoscope, Group B patients with visual laryngoscope under general anesthesia endotracheal intubation, the hemodynamie changes of two groups of patients were monitored before the induction of anesthesia （TO）, intubation （T1）, after intubation 5min （T2）, after intubation 10min （T3）, after intubation 20min （T4） and after intubation 60min （T5）, before induction of anesthesia （TO）, after intubation 10rain （T3）, after intubation 60min （T5） venous blood cortisol concentration monitoring the situation to assess patients＇ stress, intubation time and occurrence of complications were observed. Results At intubation T2, T3 moment, A, B groups BP, HR and RPP were significantly higher than TO, T1 （P〈0.05）, A group of BP, HR and RPP increased magnitude smaller than that in group B, the difference was statistically significant （P〈0.05）; T3, T5 time A, B cortisol concentrations were significantly higher in vivo two groups of patients, the difference was statistically significant （P〈0.05）, A group of patients with elevated cortisol concentration magnitude lower than group B, the difference was statistically significant （P〈0.05）; the total number of complications occurred in patients A group was significantly lower than group B （3.3% vs13.3%）, the difference was statistically significant （P〈0.05）. Conclusion Visual laryngoscope can significantly reduce blood flow in patients with non-difficult airway dynamics fluctuations, reduce patient stress, reduce the occurrence of complications and should be popularized.