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插管型喉罩与可视管芯用于全麻气管插管对心血管反应影响的比较

孙瑞强1,薛玉良2   

  1. 1. 天津市眼科医院
    2. 天津泰达心血管病医院
  • 收稿日期:2012-04-28 修回日期:2012-07-05 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 孙瑞强

Comparison of the cardiovascular response caused by intubation using ILMA(intubating laryngeal mask airway) and SOS(stylet optical system)

rui-qiang SUN 2   

  • Received:2012-04-28 Revised:2012-07-05 Published:2013-01-15 Online:2013-01-15
  • Contact: rui-qiang SUN

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摘要：

【摘要】 目的比较可视管芯(SOS)、插管型喉罩(ILMA)和Macintosh喉镜(MAC)在气管插管过程中对患者心血管各指标的影响。方法选取拟在全麻下行眼眶手术的MallamptiⅠ/Ⅱ级、ASAⅠ级的患者60例,随机分为ILMA组、SOS组、MAC组,分别接受ILMA、SOS、MAC进行气管插管,每组20例,比较入室后5min(TBL)、气管插管前(TBI)、气管插管后即刻(TAI)、气管插管后1～5min(T1～T5)的收缩压、舒张压、心率及脑电双频谱指数(BIS),并比较TBI、T1、T3的血浆去甲肾上腺素(NA)浓度。结果 T1时点SOS组患者血压和心率低于MAC组和ILMA组,差异有统计学意义(P<0.05),而MAC组和ILMA组相比差异无统计学意义(P>0.05)。血浆NA浓度SOS组在插管后1min、3min均低于MAC组和ILMA组(P<0.05),同时ILMA组在上述2个时点的NA浓度均低于MAC组(P<0.05)。结论 SOS相对于MAC和ILMA在气管插管过程中能够减轻患者的心血管应激反应,而ILMA进行气管插管时并不能减轻此反应。 

关键词: 气管插管, 传统喉镜, 插管型喉罩, 可视管芯, 心血管反应

Abstract: Abstract Objective To evaluate whether the way of intubation by intubated laryngeal mask airway (ILMA) and stylet optical system (SOS) could take advantage of intubation by macintosh laryngeal scope (MAC) in reducing cardiovascular response.Methods Sixty undergoing orbital plastic surgery patients, ASA gradeⅠor Ⅱ, airway evalutated normal, were randomly divided into three groups: Macintosh group (MAC, n=20), intubated laryngeal mask airway group (ILMA, n=20) and stylet optical system group (SOS, n=20), and all the patients of three groups received intubation by MAC, ILMA, SOS respectively after induction intravenously. Record the patients’ IBP, HR and BIS at time point 5minutes after arriving (baseline value, TBL), immediately before intubation (TBI), immediately after intubation (TAI), 1-5min after intubation (T1-T5); The blood samples of left radial artery were taken for determination of serum NE concerntration at the moment before intubation (baseline value, TBL), 1 min after intubation (T1), 3 min after intubation (T3). Results Inter-group comparison: SBP, DBP and HR of group SOS at time point T1 were lower than that of group MAC (P<0.05) and group ILMA, but no significant difference was found between group ILMA and group MAC. There is also no significant difference of plasma NE at time point TBI (P>0.05), but at time point T1 AND T3 Plasma NE concentration of group SOS is the lowest among the three groups.. Conclusion Endotracheal intubation could cause cardiovascular response compared to intubation by Macintosh laryngeal scope, intubation by ILMA could not decrease the level of cardiovascular, but SOS could decrease the cardiovascular response. Key words Tracheal intubation Macintosh laryngeal scope Intubating laryngeal mask airway Stylet optical system Cardiovascular response

Key words: Tracheal intubation, Macintosh laryngeal scope, Intubating laryngeal mask airway, Stylet optical system, Cardiovascular response