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三種不同喉鏡在腹部手術(shù)患者的氣管插管中對血流動力學(xué)影響

發(fā)布時間:2018-05-07 01:04

  本文選題:可視喉鏡 + 血流動力學(xué) ; 參考:《延邊大學(xué)》2014年碩士論文


【摘要】:目的:分析可視喉鏡、纖支鏡和直接喉鏡在氣管插管中對血流動力學(xué)影響,為臨床應(yīng)用可視喉鏡提供參考依據(jù)。 方法:選取2012年9月至2013年9月擬經(jīng)口氣管插管全身麻醉下施擇期普通外科手術(shù)的患者90例,隨機分為A組(GSVL組,30例)、B組(MDLS組,30例)和C組(FOB組,30例)。麻醉誘導(dǎo)后,分別采用三種鏡實施經(jīng)口氣管插管操作,記錄麻醉誘導(dǎo)前(To)、誘導(dǎo)后(T1),插管即刻(T2)、插管后1min、3min、5min(T3~Ts)的血流動力學(xué)指標(SBP、DBP, MAP、HR)。 結(jié)果:麻醉誘導(dǎo)后與TO時比較,三組T1的SBP、DBP、MAP較均下降(P0.05), HR變化無統(tǒng)計學(xué)意義,TO和T1三組間各項指標變化無顯著性差異。與T1比較,T2時段三組全部指標均顯著升高(P0.05)。與T0比較,T2時段FOB組的SBP、DBP、MAP、HR均顯著升高(P0.05),與MDL和GS組比較,FOB組全部指標顯著升高(P0.05)。GS與MDL組比較無顯著差異性。與T1比較,T2時段MDL組與GS組全部指標均顯著升高,MDL組氣管插管時HR顯著高于GS組(P0.05)。FOB組HR顯著高于GS組和MDL組。與T1相比,T3-T5時段三組的全部指標均顯著升高。(P0.05)。與TO相比,T3-T5時段GS組的全部指標與MDL組相比略低,但無顯著性差異,FOB組與GS和MDL組比較有顯著差異(P0.05)。與T2相比,T3-T5時段GS組與MDL組無顯著差異,FOB組與GS組、MDL組比較有顯著差異(P0.05)。 結(jié)論:1、可視喉鏡經(jīng)口氣管插管時,引起的血流動力學(xué)反應(yīng)與直接喉鏡相近 2、可視喉鏡、纖支鏡在困難氣道起著重要的作用。
[Abstract]:Objective: to analyze the effect of visual laryngoscope, fiberoptic bronchoscope and direct laryngoscope on hemodynamics in tracheal intubation, and to provide reference for clinical application of visual laryngoscope. Methods: from September 2012 to September 2013, 90 patients undergoing elective general surgery under general anesthesia were randomly divided into group A (30 cases) and group C (30 cases). After anesthesia induction, three kinds of endoscopy were used to perform the orotracheal intubation respectively. The hemodynamic indexes of SBP DBP and MAPHRA were recorded before and after induction, T1, T2 +, T2 +, T3 + T3 + Ts1, respectively. Results: compared with to after anesthesia induction, the SBPnDBPU map of T 1 group was lower than that of T 1 group (P 0.05). There was no significant difference in HR between to group and T 1 group. Compared with T 1, all indexes in T 2 group were significantly higher than that in T 2 group (P 0 05). Compared with T _ 0, the HR of FOB group was significantly higher than that of T _ 2 group. Compared with MDL and GS group, all indexes of FOB group were significantly higher than that of MDL and GS group. There was no significant difference between MDL group and MDL group. Compared with T1, HR in MDL group and GS group were significantly higher than those in GS group and MDL group at tracheal intubation. Compared with T1, all indexes of T3-T5 group were significantly higher than that of T1 group. Compared with to, all the indexes of GS group were slightly lower than those of MDL group, but there was no significant difference between MDL group and GS group and MDL group (P 0.05). There was no significant difference between GS group and MDL group in T3-T5 period compared with T2. Conclusion: the hemodynamic response induced by visual laryngoscope in orotracheal intubation is similar to that caused by direct laryngoscope. 2. Visual laryngoscope and fiberoptic bronchoscope play an important role in difficult airway.
【學(xué)位授予單位】:延邊大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2014
【分類號】:R614

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