三种不同喉镜在腹部手术患者的气管插管中对血流动力学影响

发布时间：2018-05-07 01:04

本文选题：可视喉镜 + 血流动力学　；参考：《延边大学》2014年硕士论文

【摘要】：目的：分析可视喉镜、纤支镜和直接喉镜在气管插管中对血流动力学影响,为临床应用可视喉镜提供参考依据。方法：选取2012年9月至2013年9月拟经口气管插管全身麻醉下施择期普通外科手术的患者90例,随机分为A组(GSVL组,30例)、B组(MDLS组,30例)和C组(FOB组,30例)。麻醉诱导后,分别采用三种镜实施经口气管插管操作,记录麻醉诱导前(To)、诱导后(T1),插管即刻(T2)、插管后1min、3min、5min(T3～Ts)的血流动力学指标(SBP、DBP, MAP、HR)。结果：麻醉诱导后与TO时比较,三组T1的SBP、DBP、MAP较均下降(P0.05), HR变化无统计学意义,TO和T1三组间各项指标变化无显著性差异。与T1比较,T2时段三组全部指标均显著升高(P0.05)。与T0比较,T2时段FOB组的SBP、DBP、MAP、HR均显著升高(P0.05),与MDL和GS组比较,FOB组全部指标显著升高(P0.05)。GS与MDL组比较无显著差异性。与T1比较,T2时段MDL组与GS组全部指标均显著升高,MDL组气管插管时HR显著高于GS组(P0.05)。FOB组HR显著高于GS组和MDL组。与T1相比,T3-T5时段三组的全部指标均显著升高。(P0.05)。与TO相比,T3-T5时段GS组的全部指标与MDL组相比略低,但无显著性差异,FOB组与GS和MDL组比较有显著差异(P0.05)。与T2相比,T3-T5时段GS组与MDL组无显著差异,FOB组与GS组、MDL组比较有显著差异(P0.05)。结论：1、可视喉镜经口气管插管时,引起的血流动力学反应与直接喉镜相近 2、可视喉镜、纤支镜在困难气道起着重要的作用。
[Abstract]:Objective: to analyze the effect of visual laryngoscope, fiberoptic bronchoscope and direct laryngoscope on hemodynamics in tracheal intubation, and to provide reference for clinical application of visual laryngoscope. Methods: from September 2012 to September 2013, 90 patients undergoing elective general surgery under general anesthesia were randomly divided into group A (30 cases) and group C (30 cases). After anesthesia induction, three kinds of endoscopy were used to perform the orotracheal intubation respectively. The hemodynamic indexes of SBP DBP and MAPHRA were recorded before and after induction, T1, T2 +, T2 +, T3 + T3 + Ts1, respectively. Results: compared with to after anesthesia induction, the SBPnDBPU map of T 1 group was lower than that of T 1 group (P 0.05). There was no significant difference in HR between to group and T 1 group. Compared with T 1, all indexes in T 2 group were significantly higher than that in T 2 group (P 0 05). Compared with T _ 0, the HR of FOB group was significantly higher than that of T _ 2 group. Compared with MDL and GS group, all indexes of FOB group were significantly higher than that of MDL and GS group. There was no significant difference between MDL group and MDL group. Compared with T1, HR in MDL group and GS group were significantly higher than those in GS group and MDL group at tracheal intubation. Compared with T1, all indexes of T3-T5 group were significantly higher than that of T1 group. Compared with to, all the indexes of GS group were slightly lower than those of MDL group, but there was no significant difference between MDL group and GS group and MDL group (P 0.05). There was no significant difference between GS group and MDL group in T3-T5 period compared with T2. Conclusion: the hemodynamic response induced by visual laryngoscope in orotracheal intubation is similar to that caused by direct laryngoscope. 2. Visual laryngoscope and fiberoptic bronchoscope play an important role in difficult airway.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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