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
12期
15-17
,共3页
丁卡因%麻醉,全身%血流动力学%气管拔管
丁卡因%痳醉,全身%血流動力學%氣管拔管
정잡인%마취,전신%혈류동역학%기관발관
Tetracaine%Anesthesia,general%Hemodynamics%Tracheal extubation
目的 研究丁卡因胶浆对全身麻醉拔管期血流动力学的影响.方法 将100例择期气管插管全身麻醉患者按随机数字表法分为对照组和试验组,每组50例.对照组在气管导管表面均匀涂抹无菌液态石蜡油,试验组于相同部位均匀涂抹丁卡因胶浆.记录麻醉诱导前(T1)、手术结束停止输注药物后5 min(T2)、拔管后1 min(T3)、拔管后3 min(T4)、拔管后5 min (T5)的收缩压、舒张压和心率,患者术后清醒时耐管效果,术后24h发生咽喉痛、声音嘶哑的例数.结果 两组T1、T2收缩压、舒张压、心率比较差异均无统计学意义(P＞0.05);试验组T3 ～T5收缩压、舒张压、心率明显低于对照组[收缩压:(122.3±11.3),(120.0±9.8),(112.0±6.3) mmHg(1 mmHg =0.133 kPa)比(158.3±15.0),(142.5±13.5),(133.0±14.5) mmHg;舒张压:(75.0±13.5),(75.8±10.5),(58.3±4.2) mmHg比(111.0±20.3),(106.5±12.8),(63.8±15.8) mmHg;心率:(81.9±13.7),(83.6±13.4),(60.7±3.5)次/min比(113.5±19.4),(117.5±21.7),(71.8±14.6)次/min],差异均有统计学意义(P＜0.05).试验组耐管总有效率明显高于对照组[96％(48/50)比56％(28/50)],咽喉痛和声音嘶哑发生率明显低于对照组[6％(3/50)比48％(24/50)和4％(2/50)比36％(18/50)],差异均有统计学意义(P＜0.05).结论 丁卡因胶浆可以减轻全身麻醉患者拔管期血流动力学的剧烈波动,能增强患者对气管导管的耐受性,有效降低全身麻醉气管插管所引起的咽喉痛和声音嘶哑的发生率.
目的 研究丁卡因膠漿對全身痳醉拔管期血流動力學的影響.方法 將100例擇期氣管插管全身痳醉患者按隨機數字錶法分為對照組和試驗組,每組50例.對照組在氣管導管錶麵均勻塗抹無菌液態石蠟油,試驗組于相同部位均勻塗抹丁卡因膠漿.記錄痳醉誘導前(T1)、手術結束停止輸註藥物後5 min(T2)、拔管後1 min(T3)、拔管後3 min(T4)、拔管後5 min (T5)的收縮壓、舒張壓和心率,患者術後清醒時耐管效果,術後24h髮生嚥喉痛、聲音嘶啞的例數.結果 兩組T1、T2收縮壓、舒張壓、心率比較差異均無統計學意義(P＞0.05);試驗組T3 ～T5收縮壓、舒張壓、心率明顯低于對照組[收縮壓:(122.3±11.3),(120.0±9.8),(112.0±6.3) mmHg(1 mmHg =0.133 kPa)比(158.3±15.0),(142.5±13.5),(133.0±14.5) mmHg;舒張壓:(75.0±13.5),(75.8±10.5),(58.3±4.2) mmHg比(111.0±20.3),(106.5±12.8),(63.8±15.8) mmHg;心率:(81.9±13.7),(83.6±13.4),(60.7±3.5)次/min比(113.5±19.4),(117.5±21.7),(71.8±14.6)次/min],差異均有統計學意義(P＜0.05).試驗組耐管總有效率明顯高于對照組[96％(48/50)比56％(28/50)],嚥喉痛和聲音嘶啞髮生率明顯低于對照組[6％(3/50)比48％(24/50)和4％(2/50)比36％(18/50)],差異均有統計學意義(P＜0.05).結論 丁卡因膠漿可以減輕全身痳醉患者拔管期血流動力學的劇烈波動,能增彊患者對氣管導管的耐受性,有效降低全身痳醉氣管插管所引起的嚥喉痛和聲音嘶啞的髮生率.
목적 연구정잡인효장대전신마취발관기혈류동역학적영향.방법 장100례택기기관삽관전신마취환자안수궤수자표법분위대조조화시험조,매조50례.대조조재기관도관표면균균도말무균액태석사유,시험조우상동부위균균도말정잡인효장.기록마취유도전(T1)、수술결속정지수주약물후5 min(T2)、발관후1 min(T3)、발관후3 min(T4)、발관후5 min (T5)적수축압、서장압화심솔,환자술후청성시내관효과,술후24h발생인후통、성음시아적례수.결과 량조T1、T2수축압、서장압、심솔비교차이균무통계학의의(P＞0.05);시험조T3 ～T5수축압、서장압、심솔명현저우대조조[수축압:(122.3±11.3),(120.0±9.8),(112.0±6.3) mmHg(1 mmHg =0.133 kPa)비(158.3±15.0),(142.5±13.5),(133.0±14.5) mmHg;서장압:(75.0±13.5),(75.8±10.5),(58.3±4.2) mmHg비(111.0±20.3),(106.5±12.8),(63.8±15.8) mmHg;심솔:(81.9±13.7),(83.6±13.4),(60.7±3.5)차/min비(113.5±19.4),(117.5±21.7),(71.8±14.6)차/min],차이균유통계학의의(P＜0.05).시험조내관총유효솔명현고우대조조[96％(48/50)비56％(28/50)],인후통화성음시아발생솔명현저우대조조[6％(3/50)비48％(24/50)화4％(2/50)비36％(18/50)],차이균유통계학의의(P＜0.05).결론 정잡인효장가이감경전신마취환자발관기혈류동역학적극렬파동,능증강환자대기관도관적내수성,유효강저전신마취기관삽관소인기적인후통화성음시아적발생솔.
Objective To study the effect of tetracaine jelly on hemodynamics during extubation period in general anesthesia.Methods One hundred patients who performed tracheal cannula and general anesthesia were divided into control group (50 patients) and experiment group (50 patients) by random digits table method.Control group:sterile paraffin oil was applied to the endotracheal tube.Experiment group:tetracaine jelly was applied to the endotracheal tube.The systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate(HR) were measured before the anesthesia induction(T1),5 min after stopping infusion drugs (T2),1 min after tracheal extubation (T3),3 min after tracheal extubation (T4) and 5 min after tracheal extubation (T5) were observed.The resistant effect after waking and the number of sore throat,hoarseness were recorded.Results The level of SBP,DBP,HR at T1 and T2 had no significant difference between two groups (P ＞ 0.05).The level of SBP,DBP,HR at T3-T5 in experiment group were significantly lower than those in control group [SBP:(122.3 ± 11.3),(120.0 ± 9.8),(112.0 ± 6.3) mmHg (1 mmHg =0.133 kPa) vs.(158.3 ± 15.0),(142.5 ± 13.5),(133.0± 14.5) mmHg;DBP:(75.0 ± 13.5),(75.8 ± 10.5),(58.3 ±4.2) mmHg vs.(111.0 ± 20.3),(106.5 ± 12.8),(63.8 ± 15.8) mmHg;HR:(81.9 ± 13.7),(83.6 ± 13.4),(60.7 ± 3.5) times/min vs.(113.5 ± 19.4),(117.5 ± 21.7),(71.8 ± 14.6) times/min](P ＜ 0.05).The total effective rate of tolerance in experiment group was higher than that in control group [96％(48/50) vs.56％(28/50)],the rate of sore throat and hoarseness were lower than those in control group [6％ (3/50) vs.48％ (24/50),4％ (2/50) vs.36％ (18/50)],there were significant differences (P ＜ 0.05).Conclusion Tetracaine jelly can reduce the cardiovascular response of tracheal extubation,enhance the tolerance of tracheal tube and decrease the morbidity of sore throat and hoarseness.
