老年患者可视喉镜气管插管对血流动力学影响的临床观察

Clinical Observation of Hemodynamic Effects of Endotracheal Intubation with Laryngoscope in Elderly Patients

目的:剖析可视喉镜气管插管对老年患者的血流动力学所产生的相关影响。方法:在2019年8月—2020年10月间选取本院80例老年患者(≥60岁)为研究对象均行气管插管手术将其随机分为两组,每组40例,对照组行普通喉镜气管插管,观察组行可视喉镜气管插管,对比两组诱导前(T1)、插管时(T2)、插管后1min(T3)、3min(T4)、5min(T5)时收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)及心率(HR)、心肌耗氧量指数(RPP),另比较两组气管插管使用时间、插管次数、脉搏氧饱和度(SPO2)及心率失常发生情况。结果:两组T2时的MAP、DBP、SBP、RPP相比T1时,均有降低(P<0.05);而在T3时,两组MAP、DBP、SBP、RPP相比T2时均有升高(P<0.05)且对照组相比观察组,更为显著(P<0.05);在T2时对照组心率(HR)有明显增快,且高于观察组(P<0.05);T4、T5时,各指标都恢复至T2时水平差异不显著(P>0.05)。观察组插管次数明显少于对照组(P<0.05),而插管时间与对照组相比,明显偏短(P<0.05),SPO2、心率失常发生率均低于对照组(P<0.05)。结论:针对行气管插管的老年患者采用可视喉镜进行治疗不会明显影响到其血流动力学,而且还有助于插管次数的减少,以及实现插管时间的缩短,临床应用价值突出。

Objective:To analyze the effect of endotracheal intubation with laryngoscope on hemodynamics in elderly patients.Method:Taking our hospital as the research object,80 elderly patients(≥60 years old)were selected for endotracheal intubation from August 2019-October 2020.They were randomly divided into two groups,40 cases in each group.The control group was treated with general laryngoscope endotracheal intubation,and the observation group was treated with visual laryngoscope endotracheal intubation.Before induction(T1),during intubation(T2),after intubation(T3),3 min(T4),5 min(T5)SBP,DBP,map,HR and RPP were compared in the two groups.Result:Map,DBP,SBP and RPP of the two groups decreased compared with T1(P<0.05);map,DBP,SBP and RPP of the two groups increased compared with T2(P<0.05),and the heart rate(HR)of the control group increased significantly compared with the observation group(P<0.05);at T2,the heart rate(HR)of the control group increased significantly,and was higher than that of the observation group(P<0.05);at T4 and T5,all indexes recovered to T2 The difference was not significant(P>0.05).The number of intubation in the observation group was significantly less than that in the control group(P<0.05),while the intubation time was significantly shorter than that in the control group(P<0.05),and the incidence of SpO2 and arrhythmia was lower than that in the control group(P<0.05).Conclusion:For the elderly patients with tracheal intubation,the use of visual laryngoscope for treatment will not significantly affect their hemodynamics,but also help to reduce the number of intubation,as well as shorten the intubation time,clinical application value is outstanding.