摘要
目的:探讨放置口咽通气道和鼻咽通气道的不同血流动力学变化。方法:24例美国麻醉学会(ASA)分级Ⅰ-Ⅱ级的病人,年龄16～65岁,接受标准的麻醉方法,随机分配至口咽通气道组和鼻咽通气道组。结果:两组病人在年龄、体重和性别方面无显著差异。所有两组病人在麻醉诱导之后有显著的血压降低(P<0．01),在鼻咽通气道放置的过程中,病人的收缩压较放置前有明显的升高(P<0．001),与诱导前血压相比无明显升高(P=0．808);而口咽通气道组的血压较放置前没有显著变化(P=0．619),在放置后1 min,鼻咽通气道组平均动脉压为122±21．6 mm Hg,明显较口咽通气道组103±15．3 mm Hg高,有显著差异(P=0．017),舒张压具有同样的变化情况。心率(HR)在诱导后明显下降,放置导管的过程中HR进一步下降,在放置后4 min后HR较置管前和诱导前明显下降,而在两组之间并无显著差异(P=0．372)。结论:在麻醉诱导后的病人中,鼻咽通气道的放置较口咽通气道的放置具有更加明显的血流动力学变化,不超过诱导前的水平,因此比口腔插管和鼻腔插管引起的血流动力学变化要缓和。
Objective：To compare the cardiovascular responses to the from insertion of oropharyngeal and nasopharyngeal airways in anaesthetized patients. Methods：Twenty-four ASA Ⅰ or Ⅱ patients aged 16465 year, requiring nasotracheal intubation as part of their anaesthetic management, received a standardized general anaesthetic and were randomly allocated to receive either a nasopharyngeal or an oropharyngeal airway. Results：The two groups were similar with respect to age, weight and gender. There was a significant decrease in systolic pressure following the induction of anaesthesia in both groups. Following naso- pharyngeal airway insertion, there was a significant rise in systolic pressure above pre-insertion levels （P〈0. 001）, though not above pre-induction levels （P = 0. 808）. There was no significant change in the oropharyngeal airway insertion group （P = 0. 619）. At one minute post-insertion, the mean （SD） systolic pressure in the nasopharyngeal insertion group, 122 （21.6） mm Hg, was significantly greater than that in the oropharyngeal insertion group, 103 （15.3） mm Hg （P = 0. 017）. Diastolic pressure followed a similar pattern. In both groups, heart rate fell after induction and fell further after insertion, and at four post-insertion was significantly lower than pre-induction and pre-insertion levels. There was no significant difference in heart rates between the two groups （P = 0. 372）. Conclusion：The pressor response following the insertion of nasopharyngeal airways in anaesthetized patients is significantly greater than that following the insertion of oropharyngeal airways. However, the mean rise in arterial pressure does not exceed pre-induction level, and thus the response is less severe than that likely to be associated with orotracheal or nasotracheal intubation.
出处
《中国临床医学》
北大核心
2007年第2期242-243,共2页
Chinese Journal of Clinical Medicine
关键词
全身麻醉
并发症
鼻腔插管
Anaesthesia
Complications
Intubation nasal
