摘要
目的比较Lightwand光棒（LW）与Macintosh直接喉镜（MAC）经口气管插管对心血管反应的影响。方法将择期妇科手术患者40例随机分为LW组和MAC组,每组各20例,麻醉诱导后分别用LW或MAC实施经口气管插管。监测麻醉诱导前后、颈前光点或显露声门、气管插管即刻和气管插管后5 min内桡动脉有创收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和心率（HR）的变化;记录气管插管时间以及插管后血压（BP）及HR最大值出现时间。结果 MAC组气管插管时间明显长于LW组（P〈0.05）。麻醉诱导后两组SBP、DBP和MAP均比麻醉诱导前显著降低（P〈0.05）;颈前光点或显露声门BP和HR较麻醉诱导后无明显变化（P〉0.05）;气管插管后血压比麻醉诱导后显著升高（P〈0.05）,持续约1~2 min后逐渐下降至麻醉诱导后水平;观察期间两组血压升高均未超过麻醉诱导前水平（P〉0.05）。气管插管后两组HR比麻醉诱导前、后均显著升高（P〈0.05）,持续约3 min。两组间BP和HR在各对应时间点差异均无显著性（P〉0.05）。结论采用LW与MAC实施经口气管插管可产生类似的心血管反应。
[ Objective ] To compare the cardiovascular responses to orotracheal intubation with Lightwand （LW） or Macintosh direct laryngoscope （MAC）. [Methods] Forty gynecologial patients requiring orotracheal intuhation were randomly allocated to LW （n=20） or MAC （n=20）. Orotracheal intubation was performed using a LW or a MAC. lnva- sive systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean arterial pressure （MAP）, and heart rate （HR） were recorded before and after induction, at the time of seeing light spot or exposing the glottic opening, at intuba- tion and 5 minutes after intubation with 1-minute interval. The intubation time was noted. The time to maximal blood pressure （BP） and HR was also noted. [Results] The intuhation time was longer in MAC group than in LW group （P 〈0.05）. After anesthetic, induction, SBP, DBP and MAP in both groups decreased significantly compared to the preiuduction values （P 〈0.05）. At the time of seeing light spot or exposing the glottie opening, BP and HR in two groups were not significantly different compared to the postinduction values （P 〉0.05）. After intubation, BP in both groups increased greatly in comparison with postinduetion （P 〈0.05）, but these hemodynamie changes lasted only 1 to 2 minutes and then decreased gradually to the postinduction level. The rise of BP in both groups did not exceed the preinduction values （P〉0.05）. After intubation, HR in two groups increased significantly compared to the prein- duction and postinduetion （P 〈0.05）, and increase in HR lasted for 3 minutes. There was no significant difference in BP and HR at any time point between two groups （P〉0.05）. [ Conclusion] The cardiovascular responses to orotra- cheal intubation using a LW or MAC were similar.
出处
《中国内镜杂志》
CSCD
北大核心
2014年第1期76-79,共4页
China Journal of Endoscopy
关键词
光棒
直接喉镜
经口气管插管
心血管反应
lightwand
macintosh direct laryngoscope
orotracheal intubation
cardiovascular responses
