帝视内窥镜与易安视频喉镜全麻插管对胃肠道肿瘤术后疼痛及炎症应激反应的影响

Effect of Disposcope and E. An Video Laryngoscope on Postoperative Pain and Inflammatory Stress Response in Gastrointestinal Tumor Patients with General Anesthesia Intubation

目的比较帝视(Disposcope)内窥镜与易安(E. An)视频喉镜全麻插管对胃肠道肿瘤术后咽喉疼痛及炎症应激反应的影响。方法采用抽签法将160例拟行全麻插管的胃肠道肿瘤患者随机分为D组与E组,各80例。比较2组在插管前和插管后5 min的血清炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)]和应激激素指标[血管紧张素Ⅱ(ATⅡ)、皮质醇(Cor)、肾素(Rn)]水平变化,以及术后咽喉疼痛情况。结果 2组插管后5 min的血清CRP、TNF-α、IL-6水平均较插管前明显上升(P <0. 05),D组CRP明显高于E组(P <0. 05),E组IL-6明显高于D组(P <0. 05)。2组插管后5 min的血清ATⅡ、Cor、Rn水平均较插管前明显上升(P <0. 05),组间比较无统计学意义(P> 0. 05)。2组术后咽喉疼痛比较,差异无统计学意义(P> 0. 05)。结论帝视内窥镜与易安视频喉镜均可减轻插管的难度,舒适性好,且不会造成过大的炎症应激损伤,是全身麻醉插管的重要辅助工具。

Objective To investigate the effect of Disposcope and E.An video laryngoscope on postoperative pain and inflammatory stress response in gastrointestinal tumor patients with general anesthesia intubation. Methods 160 patients with gastrointestinal tumors undergoing general anesthesia were randomly divided into group D and group,with 80 cases in each group.Serum inflammatory factors[C reactive protein（CRP）,tumor necrosis factor-alpha（TNF-α）,interleukin-6（IL-6）] and stress hormone index [angiotensin Ⅱ（AT Ⅱ）,cortisol（Cor）,renin（Rn）] before and 5 min after intubation and postoperative sore throat were compared between the 2 groups. Results The levels of serum CRP,TNF-and IL-6 in the 2 groups 5 min after intubation were significantly higher than those before intubation（ P〈0.05）.The CRP in the group D was significantly higher than that of group E（ P〈0.05）,and the IL-6 in the group E was significantly higher than that of group D（ P〈0.05）.The serum levels of AT,Ⅱ,Cor in the 2 groups 5 min after intubationwere significantly higher than those before intubation（ P〈0.05）,and there was no significant difference between the 2 groups（ P〉0.05）.There were no significant difference between the 2 groups in postoperative throat pain（ P〉0.05）. Conclusion Disposcope and E.An video laryngoscope can reduce the difficulty of intubation,are comfortable,and do not cause excessive inflammatory stress damage,both of which are important auxiliary tool for general anesthesia intubation.