比较不同的视频喉镜应用于正常和高血压患者心排出量与血流动力学反应的研究

发布时间：2018-04-30 23:12

本文选题：动脉血压 + 反应　；参考：《华中科技大学》2015年博士论文

【摘要】：背景：采用传统Macintosh喉镜进行气管插管可能会引起严重的心血管并发。目前大多研究显示用视频喉镜进行气管插管时对血流动力学的影响结论不一致,并且视频喉镜在气管插管时对心排出量的影响少见报道。方法：我们采用3种不同插管设备[Macintosh喉镜(Macintosh laryngoscope, MAC),UE视频喉镜(UE videolaryngoscopy (?), UE),和UE视频管芯(UEvideo intubation stylet (?), VS)]对正常血压组患者60人和高血压组患者60人进行气管插管,观察其对患者心排出量和血流动力学的影响。采用LidcoRapidv2(?)记录插管前和插管后5分钟内每分钟患者的心脏指数(Cardiac index, CI),每搏指数(Stroke volume index, SVI),心率(heart rate,HR),收缩压(systolic blood pressure, SBP)和舒张压(diastolic blood pressure, DBP),同时也记录患者的咽喉痛情况。结果：高血压患者中UE组插管时间明显缩短(p=0.01),在正常血压组中三种插管设备对血流动力学影响无明显差异。高血压患者组中,采用MAC时患者插管后3分钟的SBP和DBP较采用其他两种设备明显升高(p0.05),但对CI, SVI和HR的影响,三者之间无明显差异。咽喉痛在所有组中均无明显差异。结论：在高血压患者中采用UE和VS均较MAC减轻气管插管时的血流动力学反应,但在正常血压患者中无明显差异。
[Abstract]:Background: tracheal intubation with traditional Macintosh laryngoscope may lead to severe cardiovascular complications. At present, most studies show that the effect of video laryngoscope on hemodynamics is inconsistent, and the effect of video laryngoscope on cardiac output during tracheal intubation is rarely reported. Methods: endotracheal intubation was performed in 60 patients with normal blood pressure and 60 patients with hypertension by using three different intubation devices (Macintosh laryngoscope, Macintosh laryngoscope, MACCE-UE video laryngoscope, UE videolaryngoscopy, UEX, and UE video intubation stylet). To observe its effect on cardiac output and hemodynamics. Lidco Rapidv2) Cardiac index, stroke volume index, heart rate index, systolic blood pressure, SBP) and diastolic blood pressure were recorded before and 5 minutes after intubation. Results: the intubation time in UE group was significantly shorter than that in normal blood pressure group, but there was no significant difference between the three intubation devices in normal blood pressure group. In the hypertensive group, the SBP and DBP of the patients treated with MAC at 3 minutes after intubation were significantly higher than those of the other two devices, but there was no significant difference among them in the effect of CI, SVI and HR. There was no significant difference in throat pain in all groups. Conclusion: both UE and vs can reduce the hemodynamic response during tracheal intubation in patients with hypertension, but there is no significant difference in the patients with normal blood pressure.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R614

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