中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
3期
30-33
,共4页
田悦%韩光%归东梅%马铃
田悅%韓光%歸東梅%馬鈴
전열%한광%귀동매%마령
喉面罩%气管插管%血流动力学%眼内压%青光眼
喉麵罩%氣管插管%血流動力學%眼內壓%青光眼
후면조%기관삽관%혈류동역학%안내압%청광안
Laryngeal masks%Endotracheal tube%Hemodynamics%Intraocular pressure%Glaucoma
目的 研究喉罩与气管插管对青光眼患儿血流动力学和眼内压的影响.方法 选取拟择期在全身麻醉下行小梁切开术的青光眼患儿50例,按随机数字表法将患儿分成气管插管组(TT组)和喉罩组,每组25例.分别记录气管插管或置入喉罩的操作时间;咪达唑仑用量;麻醉诱导后(T1)、气管插管或置入喉罩即刻(T2)及气管插管或置入喉罩后1 min(T3)、2min(T4)、3min(T5)、5 min(T)的心率、平均动脉压(MAP)、末梢灌注指数(TPI)和眼内压.结果 两组患儿咪达唑仑用量、操作时间比较差异均无统计学意义(P＞0.05).与T1比较,TT组T2～T4心率、眼内压升高,T2～T3MAP升高,T2～ T5TPI降低,差异均有统计学意义(P＜0.05);喉罩组各时点心率、MAP、TPI、眼内压比较差异均无统计学意义(P＞0.05).喉罩组T2～T4心率、MAP、眼内压低于TT组[心率:(119.3±8.9)、(117.6±8.5)、(115.2±6.9)次/min比(131.3±7.1)、(128.1±6.8)、(123.2±8.6)次/min,MAP:(36.9±5.1)、(37.1±4.8)、(34.7±4.6) mmHg (1mmHg =0.133 kPa)比(44.1±4.9)、(42.8±5.5)、(41.9±7.1)mmHg,眼内压:(27.6±2.5)、(27.0±2.0)、(25.9±2.3) mmHg比(34.2±2.2)、(32.9±1.6)、(31.1±2.2) mmHg],T2～T5TPI高于TT组(3.25±0.28、2.99±0.26、3.15±0.31、3.40±0.30比2.69±0.29、2.22±0.27、2.41±0.30、2.66±0.33),差异均有统计学意义(P＜0.05).结论 青光眼患儿全身麻醉下置入喉罩后心率、MAP、TPI和眼内压均未见显著变化,诱导过程平稳,值得临床推广应用.
目的 研究喉罩與氣管插管對青光眼患兒血流動力學和眼內壓的影響.方法 選取擬擇期在全身痳醉下行小樑切開術的青光眼患兒50例,按隨機數字錶法將患兒分成氣管插管組(TT組)和喉罩組,每組25例.分彆記錄氣管插管或置入喉罩的操作時間;咪達唑崙用量;痳醉誘導後(T1)、氣管插管或置入喉罩即刻(T2)及氣管插管或置入喉罩後1 min(T3)、2min(T4)、3min(T5)、5 min(T)的心率、平均動脈壓(MAP)、末梢灌註指數(TPI)和眼內壓.結果 兩組患兒咪達唑崙用量、操作時間比較差異均無統計學意義(P＞0.05).與T1比較,TT組T2～T4心率、眼內壓升高,T2～T3MAP升高,T2～ T5TPI降低,差異均有統計學意義(P＜0.05);喉罩組各時點心率、MAP、TPI、眼內壓比較差異均無統計學意義(P＞0.05).喉罩組T2～T4心率、MAP、眼內壓低于TT組[心率:(119.3±8.9)、(117.6±8.5)、(115.2±6.9)次/min比(131.3±7.1)、(128.1±6.8)、(123.2±8.6)次/min,MAP:(36.9±5.1)、(37.1±4.8)、(34.7±4.6) mmHg (1mmHg =0.133 kPa)比(44.1±4.9)、(42.8±5.5)、(41.9±7.1)mmHg,眼內壓:(27.6±2.5)、(27.0±2.0)、(25.9±2.3) mmHg比(34.2±2.2)、(32.9±1.6)、(31.1±2.2) mmHg],T2～T5TPI高于TT組(3.25±0.28、2.99±0.26、3.15±0.31、3.40±0.30比2.69±0.29、2.22±0.27、2.41±0.30、2.66±0.33),差異均有統計學意義(P＜0.05).結論 青光眼患兒全身痳醉下置入喉罩後心率、MAP、TPI和眼內壓均未見顯著變化,誘導過程平穩,值得臨床推廣應用.
목적 연구후조여기관삽관대청광안환인혈류동역학화안내압적영향.방법 선취의택기재전신마취하행소량절개술적청광안환인50례,안수궤수자표법장환인분성기관삽관조(TT조)화후조조,매조25례.분별기록기관삽관혹치입후조적조작시간;미체서륜용량;마취유도후(T1)、기관삽관혹치입후조즉각(T2)급기관삽관혹치입후조후1 min(T3)、2min(T4)、3min(T5)、5 min(T)적심솔、평균동맥압(MAP)、말소관주지수(TPI)화안내압.결과 량조환인미체서륜용량、조작시간비교차이균무통계학의의(P＞0.05).여T1비교,TT조T2～T4심솔、안내압승고,T2～T3MAP승고,T2～ T5TPI강저,차이균유통계학의의(P＜0.05);후조조각시점심솔、MAP、TPI、안내압비교차이균무통계학의의(P＞0.05).후조조T2～T4심솔、MAP、안내압저우TT조[심솔:(119.3±8.9)、(117.6±8.5)、(115.2±6.9)차/min비(131.3±7.1)、(128.1±6.8)、(123.2±8.6)차/min,MAP:(36.9±5.1)、(37.1±4.8)、(34.7±4.6) mmHg (1mmHg =0.133 kPa)비(44.1±4.9)、(42.8±5.5)、(41.9±7.1)mmHg,안내압:(27.6±2.5)、(27.0±2.0)、(25.9±2.3) mmHg비(34.2±2.2)、(32.9±1.6)、(31.1±2.2) mmHg],T2～T5TPI고우TT조(3.25±0.28、2.99±0.26、3.15±0.31、3.40±0.30비2.69±0.29、2.22±0.27、2.41±0.30、2.66±0.33),차이균유통계학의의(P＜0.05).결론 청광안환인전신마취하치입후조후심솔、MAP、TPI화안내압균미견현저변화,유도과정평은,치득림상추엄응용.
Objective To compare the response of haemodynamics and intraocular pressure (IOP) to laryngeal mask airway (LMA) and tracheal intubation (TT) in children with glaucoma.Methods A prospective,randomized study was conducted in 50 glaucomatous children,scheduled to undergo trabeculectomy and divided into LMA group (25 cases) and TT group (25 cases) by random digits table method.Endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam was noted in each patient.Heart rate (HR),mean arterial pressure (MAP),tip perfusion index (TPI),IOP were measured after anesthesia induction (T1),endotracheal intubation or placement laryngeal mask immediately (T2),endotracheal intubation or placement after laryngeal mask 1 min (T3),2 min (T4),3 min(T5),5 min(T6).Results There was no significant difference in endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam between two groups (P ＞ 0.05).Compared with T1,HR,IOP were increased at T2-T4,MAP was increased at T2-T3,TPI was decreased at T2-T5 in TT group,there was significant difference(P ＜ 0.05).There was no significant difference in HR,MAP,TPI,IOP among different points in LMA group (P ＞ 0.05).HR,MAP,IOP in LMA group at T2-T4 were lower than those in TT group [HR:(119.3 ±8.9),(117.6 ±8.5),(115.2 ±6.9) beats/min vs.(131.3 ±7.1),(128.1 ±6.8),(123.2 ± 8.6)beats/min,MAP:(36.9 ± 5.1),(37.1 ±4.8),(34.7 ±4.6) mmHg (1 mmHg =0.133 kPa) vs.(44.1 ± 4.9),(42.8 ± 5.5),(41.9 ± 7.1) mmHg,IOP:(27.6 ± 2.5),(27.0 ± 2.0),(25.9 ± 2.3) mmHg vs.(34.2 ± 2.2),(32.9 ± 1.6),(31.1 ± 2.2) mmHg],TPI at T2-T5 was higher than that in TT group (3.25 ± 0.28,2.99 ± 0.26,3.15 ± 0.31,3.40 ± 0.30 vs.2.69 ± 0.29,2.22 ± 0.27,2.41 ± 0.30,2.66 ± 0.33),and there was significant difference (P ＜0.05).Conclusion Insertion of LMA in glaucomatous children is not associated with significant changes in haemodynamics and IOP response and offers advantages over tracheal intubation.
