右美托咪定联合帝视内镜在全身麻醉气管插管老年患者中的应用效果

Application effect of Dexmedetomidine combined with Disposcope endoscope in elderly patients with general anesthesia endotracheal intubation

目的 探讨右美托咪定联合帝视内镜在全身麻醉气管插管老年患者中的应用效果。方法 选取2013年1月~2015年12月我院收治的80例老年全身麻醉手术患者作为研究对象,按照随机数字表法分为对照组和观察组,各40例。手术中,对照组采用直接喉镜联合氯化钠注射液,观察组采用右美托咪定联合帝视内镜。比较两组插管前后的平均动脉压、心率变化情况,并对两组患者的插管时间、苏醒时间、拔管时间、一次插管成功率、咽部不适发生率进行比较。结果 对照组插管后的心率快于插管前,平均动脉压高于插管前,差异有统计学意义（P〈0.05）。观察组治疗前后的心率、平均动脉压比较,差异无统计学意义（P〉0.05）。观察组插管后的心率慢于对照组,平均动脉压低于对照组,差异有统计学意义（P〈0.05）。观察组的插管时间、苏醒时间、拔管时间显著短于对照组,差异有统计学意义（P〈0.05）。观察组的一次插管成功率为100%,显著高于对照组的80%,差异有统计学意义（P〈0.05）。观察组的咽部不适发生率为10%,显著低于对照组的28%,差异有统计学意义（P〈0.05）。结论 在老年患者气管插管全身麻醉手术过程中采用右美托咪定联合帝视内镜,可有效稳定患者手术过程中的生命体征,促进插管的顺利进行。

Objective To explore the application effect of Dexmedetomidine combined with Disposcope endoscopic in elderly patients with general anesthesia endotracheal intubation.nethods 80 cases of elderly patients with general anesthesia surgery in our hospital from January 2013 to December 2015 were selected and divided into the control group and the observation group by taking the digital random table method,each group had 40 cases.In the operation,the control group was used direct laryngoscope in combination with sodium chloride injection,the observation group was used Dexmedetomidine combined with Disposcope endoscope.The change of the average arterial pressure and heart rate before and after intubation were compared between the two groups,and intubation time,recovery time,extubation time, once success rate of intubation and the incidence rate of pharyngeal discomfort were compared between the two groups. Results The heart rate of the control group after intubation was faster than that before intubation,and the mean arterial pressure of the control group after intubation was higher than that before intubation,with significant difference （P〈0.05）. There was no significant difference in the heart rate and average arterial pressure after and before intubation in the ob- servation group （P〉0.05）.The heart rate of the observation group after intubation was slower than that of the control group,and the mean arterial pressure of the observation group after intubation was lower than that of the control group, with significant difference （P〈0.05）.The intubation time,recovery time,extubation time in the observation group was shorter than that in the control group,with significant difference （P〈0.05）.The success rate of intubation in the observa- tion group was 100%,which was higher than 80% in the control group,with significant difference （P〈0.05）.The inci- dence rate of pharyngeal discomfort in the observation group was 10%,which was lower than 28% in the control group, with significant difference （P〈0.05）.Conclusion In elderly patients with tracheal intubation anesthesia surgery process, using the Dexmedetomidine combined with Disposcope endoscope can be effective to remain stable vital signs in the process of operation,facilitate the smooth progress of the intubation.