CAJ | 학술논문

目的:观察瑞芬太尼全麻诱导时视可尼喉镜(shikani optical stylet,SOS)与直接喉镜气管插管对患者血流动力学变化的影响.方法:非心肺疾病择期手术患者60例,ASAⅠ级,年龄20~40岁,体重40~60 kg,随机分为视可尼喉镜组(S)组和直接喉镜组(H)组,每组30例.记录麻醉诱导前(T0)、气管插管前即刻(T1)、气管插管后1 min(T2)、插管后2 min(T3)及插管后3 min(T4)的SBP、DBP、HR变化,记录插管试插例次,气管插管时间.术后随访气管插管的相关并发症.结果:两组均顺利完成气管内插管.S组平均插管时间为(36±12)s, H组平均插管时间为(20±8)s,两组插管时间差异有统计学意义(P<0.05).组内比较,与T0相比,两组T1SDB、DBP均明显下降(P<0.05),两组HR无明显减慢(P>0.05);与T1相比,T2时两组SDB、DBP均明显升高(P<0.05),两组HR无明显增快(P>0.05);与基础值T0相比,S组T2时SDB降低(P<0.05),S组T2、T3、T4时HR增快(P<0.05).组间比较,两组血流动力学的改变,差异无统计学意义(P>0.05).S组有1例患者拔管后出现暂时性声音嘶哑,2例自诉咽喉疼痛,H组有2例患者诉咽喉疼痛,3例咽喉不适.结论:瑞芬太尼全麻诱导时,与直接喉镜相比,视可尼喉镜气管插管对患者血流动力学变化的影响无明显差异,可作为临床气管插管常规使用.
목적:관찰서분태니전마유도시시가니후경(shikani optical stylet,SOS)여직접후경기관삽관대환자혈류동역학변화적영향.방법:비심폐질병택기수술환자60례,ASAⅠ급,년령20~40세,체중40~60 kg,수궤분위시가니후경조(S)조화직접후경조(H)조,매조30례.기록마취유도전(T0)、기관삽관전즉각(T1)、기관삽관후1 min(T2)、삽관후2 min(T3)급삽관후3 min(T4)적SBP、DBP、HR변화,기록삽관시삽례차,기관삽관시간.술후수방기관삽관적상관병발증.결과:량조균순리완성기관내삽관.S조평균삽관시간위(36±12)s, H조평균삽관시간위(20±8)s,량조삽관시간차이유통계학의의(P<0.05).조내비교,여T0상비,량조T1SDB、DBP균명현하강(P<0.05),량조HR무명현감만(P>0.05);여T1상비,T2시량조SDB、DBP균명현승고(P<0.05),량조HR무명현증쾌(P>0.05);여기출치T0상비,S조T2시SDB강저(P<0.05),S조T2、T3、T4시HR증쾌(P<0.05).조간비교,량조혈류동역학적개변,차이무통계학의의(P>0.05).S조유1례환자발관후출현잠시성성음시아,2례자소인후동통,H조유2례환자소인후동통,3례인후불괄.결론:서분태니전마유도시,여직접후경상비,시가니후경기관삽관대환자혈류동역학변화적영향무명현차이,가작위림상기관삽관상규사용.
objective:To observe the hemodynamic differences of patients to orotracheal intubation using a Shikani Optical Stylet(SOS) laryngoscope or a direct laryngoscope when remifentanil was applied in induction of general anesthesia.Method:60 ASA gradeⅠPatients(femal),aged 20 to 40 years,weighing 40 to 60 kg scheduled for elective Gynecology perioneoscope surgical operations,were randomly divided into 2 groups. Group S (n=30):using Shikani Optical Stylet(SOS);group H(n=30):using direct laryngoscope . The following variables were recorded:SBP、DBP、HR at T0( before anesthetic induction)、T1( immediately before intubation) and 1(T2)、2(T3)、3(T4)minute after intubation. The attempt times ,intubation time and complications were recorded. Result:The average time of intubation in two group were(36±12)s,(20±8)s respectively,and the time in group H was significantly shorter than that in group S.At T1 compared to T0,SDB and DBP decreased dramatically in both H group and S group(P<0.05), but HR was not significantly different in two group(P>0.05);At T2 compared to T1,Tracheal intubation caused significant increases in SBP and DBP in both H group and S group,but HR was not significantly different in two group(P>0.05);Compared with the basic values(T0)in group S ,SDB at T2 was lower(P<0.05),and HR in l、2、3 minute after intubation was all increased significantly(P<0.05). the hemodynamic differences of patients to orotracheal intubation in both H group and S group was not significantly different(P>0.05).Conclusion:The hemodynamic responses of patients to orotracheal intubation using a Shikani Optical Stylet(SOS)laryngoscope is not significantly different from those using a direct laryngoscope.