CAJ | 학술논문

目的比较直视喉镜和纤维支气管镜引导左侧双腔支气管插管对患者应激反应的影响。方法选择ASAⅠ或Ⅱ级开胸手术患者80例,年龄在28～75岁,随机均分成纤支镜组（F组）和直接喉镜组（M组）,每组40例,记录置管时间、定位时间及总插管时间。观察插管前1min、插管后1、3、10min的HR、MAP、血浆去甲肾上腺素（NE）和肾上腺素（E）的变化。结果 M组置管时间明显少于F组,定位时间、总插管时间明显长于F组（P〈0.01）。与插管前1min比较,插管后1、3min两组HR明显增快、MAP明显升高（P〈0.05）;血浆NE、E水平显著升高（P〈0.05）。M组插管后1、3minNE、E水平显著高于F组（P〈0.05）。结论与直接喉镜相比,纤维支气管镜引导左侧双腔管插管定位准确,耗时较少,且对患者应激反应较弱。
목적비교직시후경화섬유지기관경인도좌측쌍강지기관삽관대환자응격반응적영향。방법선택ASAⅠ혹Ⅱ급개흉수술환자80례,년령재28～75세,수궤균분성섬지경조（F조）화직접후경조（M조）,매조40례,기록치관시간、정위시간급총삽관시간。관찰삽관전1min、삽관후1、3、10min적HR、MAP、혈장거갑신상선소（NE）화신상선소（E）적변화。결과 M조치관시간명현소우F조,정위시간、총삽관시간명현장우F조（P〈0.01）。여삽관전1min비교,삽관후1、3min량조HR명현증쾌、MAP명현승고（P〈0.05）;혈장NE、E수평현저승고（P〈0.05）。M조삽관후1、3minNE、E수평현저고우F조（P〈0.05）。결론여직접후경상비,섬유지기관경인도좌측쌍강관삽관정위준학,모시교소,차대환자응격반응교약。
Objective To compare the effect on the stress response in patients of laryngoscope and bronchoscope to guide the left double-lumen endotracheal intubation. Methods Selected 80 patients of ASA Ⅰ or Ⅱundergoing thoracic surgery,aged 28 to 75 years old,who were randomly divided into macintosh directoscope group （group M） and fiberoptic bronchoscope group （group F）,40 cases per group,recorded cathetering time,positioning time and total intubation time. Observed changes of HR,MAP,plasma level of norepinephrine （NE） and epinephrine （E） 1min before intubation,and 1,3,10 min after intubation.Results The cathetering time of group M was significantly less than that of group F,and positioning time,total intubation time was significantly longer than group F （P0.01）. And compared with that of 1min before intubation,HR,MAP as well as plasma levels of NE,E of 1,3 min after intubation increased significantly and became higher （P0.05）. Levels of plasma NE,E of 1,3 min after intubation of group M was significantly higher than those of group F （P0.05）.Conclusion compared with direct laryngoscopy,using fiberoptic bronchoscope to guide the left double-lumen tube intubation can position accurately,consume less time,and have less stress response in patients.