帝视内窥镜用于高血压患者气管内插管时血流动力学变化影响的观察

摘要

Objective:Discope for observation and comparison of tracheal intubation in patients with hypertension. Meth-ods:Selective operation in 40 cases,age 40~72 years old,ASA Ⅱ~Ⅲ and Among the 38 patients with primary hyper-tension,2 cases of secondary hypertension. The degree of hypertension between109. 5/180 mmhg~100/120 mmhg,Av-erage170/105 mmhg. Randomly divided into Discopo group and laryngoscope group. Changes in blood( BP),mean airway pressure( MAP),heart rate( hR)and tracheal intubation time were measured before anesthesia induction(T1),after anesthesia induction(T2 ),immediately after intubation,1 minute(T3)after intubation. Rate pressure product( RPP) were calculated. Results:In Discopo group,after the induction BP declined greatly compared with those before induction, hR increased slightly,There were no significant differences in(P>0. 05);Intubation of BP,hR increased lightly,but the difference was not statistically significant(P>0. 05). In Laryngoscope group,after the induction,BP and hR declined greatly,There were no significant differences in(P>0. 05). Immediately after intubation,1 minute after intubation the BP and hR were higher than the Discopo group at the same period. The difference was statistically significant(P﹤0. 05). Conclusions:In comparison to laryngoscope,trachea intubation with laryngoscope resulted in less alterations in hemody-namic responses. Discopo will not cause fluctuations in blood pressure,heart rate.%目的：帝视内窥镜用于高血压患者气管内插管时的观察与比较。方法：选择择期手术合并高血压患者40例，年龄40~72岁，ASAⅡ~Ⅲ级，其中原发性高血压38例，继发性高血压2例。高血压程度介于109.5/180~100/120 mmhg，平均170/105 mmhg。随机分为帝视内窥镜组（Ⅰ组）和普通喉镜组（Ⅱ组）。记录患者麻醉诱导前（T1）、麻醉诱导后（T2）、插管成功（T3）及插管后1 min（T4）的hR、MAP、BP，心率与收缩压乘积（RPP）。结果：Ⅰ组诱导后的BP与诱导前比明显下降，hR轻度上升，差异均无统计学意义（ P>0.05）；插管即刻的BP、hR轻度上升，但差异无统计学意义（ P>0.05）。Ⅱ组于诱导后的BP及hR均较诱导前明显下降，差异无统计学意义（ P>0.05）；于插管即刻、插管后1 min的BP及hR均高于Ⅰ组的同期水平，差异有统计学意义（ P﹤0.05）。结论：帝视内窥镜、普通喉镜气管插管对血流动力学均有影响，帝视内窥镜在高血压患者气管插管时对血压、心率的影响较轻，不会引起血压、心率的剧烈波动。