地佐辛复合依托咪酯对高血压患者全麻PLMA喉罩置入的效果观察

发布时间：2018-06-12 19:43

本文选题：地佐辛 + 高血压　；参考：《吉林大学》2014年硕士论文

【摘要】：随着当今社会医疗保健水平的不断提高，科学技术水平迅猛发展，人们对手术的舒适性、安全性也提出了新的要求。然而伴随居民生活水平逐步改善，生活环境、饮食结构的改变，，原发性高血压的患病率也在不断攀升并呈年轻化发展。如何让原发性高血压患者舒适平稳的度过麻醉诱导期，是每一名麻醉医生不懈的追求。气道食道双管喉罩(ProSeal-LMA)作为保持气道通畅的工具，插入技术简单易学，无需使用喉镜，能够减少或避免造成气道、声带的机械性损伤，相比传统的气管插管应激反应轻，血流动力学稳定。但是对于高血压患者而言，由于血管壁弹性差，重要脏器长期受累功能下降，在静脉麻醉药物诱导过程中仍可能发生剧烈的循环波动、喉罩置入条件不佳及药物不良反应从而产生强烈的应激反应。根据这一现象，如何让PLMA喉罩的优势最大程度体现在高血压患者身上成为了麻醉医生的新一课题。本文将对此问题进行临床研究和观察，比较依托咪酯复合地佐辛或芬太尼对高血压患者全麻PLMA喉罩置入的效果，并阐述及讨论观察结果，目的是为临床工作提供切实可行的麻醉方案。
[Abstract]:With the development of medical and health care and the rapid development of science and technology, new demands have been put forward for the comfort and safety of surgery. However, with the gradual improvement of living standard, living environment and dietary structure, the prevalence of essential hypertension is rising and developing younger. It is every anesthesiologist's unremitting pursuit how to make essential hypertension patient pass anesthesia induction period comfortably and smoothly. ProSeal-LMAA can be used as a tool to keep airway patency. The insertion technique is simple and easy to learn. It can reduce or avoid mechanical injury of airway and vocal cord without laryngoscope. Compared with traditional tracheal intubation, the stress response of tracheal intubation is lighter than that of traditional tracheal intubation. Hemodynamics is stable. However, for patients with hypertension, because of the poor elasticity of vascular wall and the decline of the long-term involved function of important organs, severe circulatory fluctuations may still occur during the induction of intravenous anesthetic drugs. Poor laryngeal mask placement and adverse drug reactions result in a strong stress response. According to this phenomenon, how to maximize the advantage of PLMA laryngeal mask in hypertensive patients has become a new subject for anesthesiologists. In this paper, we will study and observe the effect of etomidate combined with dizosin or fentanyl on PLMA laryngeal mask implantation in patients with hypertension. The purpose is to provide a feasible anesthetic scheme for clinical work.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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