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不同插管方法对腹部手术高血压患者血流动力学的影响 被引量:21

Hemodynamic variations during tracheal intubation with intubating laryngeal mask airway versus direct laryngoscope in hypertensive patients
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摘要 目的 比较经插管型喉罩(ILMA)气管内插管与经直视喉镜下(DLS)气管内插管时高血压患者的心血管反应及血管紧张素Ⅱ(AngⅡ)的变化.方法 选择择期行腹部手术的高血压患者120例,经医院伦理委员会审核通过,按随机数字表法随机分为插管型喉罩组(Ⅰ组)和经直视喉镜组(D组),比较两组患者气管内插管前后有创动脉压及血管紧张素Ⅱ(AngⅡ)的变化.结果 D组置人直视喉镜即刻(T4) Sp(123±9) mm Hg(1 mm Hg=0.133 kPa),Dp(71 ±9) mm Hg,AngⅡ(67±12) pg/ml.Ⅰ组置入插管型喉罩即刻(T4)Sp (105 ±7) mm Hg,Dp(64±6) mm Hg,AngⅡ(45±6) pg/ml.两组间有创动脉压与血管紧张素Ⅱ(AngⅡ)的变化Ⅰ组均显著小于D组,两组间比较P<0.05;两组气管插管完成即刻(T5)D组:Sp(125 ±7) mm Hg,Dp(72±8) mm Hg,AngⅡ(87±13) pg/ml.Ⅰ组Sp(112±6) mm Hg,Dp(63 ±5) mm Hg,AngⅡ(47±7)pg/ml.两组间有创动脉压与血管紧张素Ⅱ(AngⅡ)的变化Ⅰ组均显著小于D组,两组间比较P<0.05.结论 使用经插管型喉罩(ILMA)行气管内插管可显著降低高血压患者的心血管系统的剧烈反应,避免心血管意外的发生. Objective To compare the variations of cardiovascular responses and vascular angiotensin Ⅱ (Ang Ⅱ ) in hypertensive patients during tracheal intubation with intubating laryngeal mask airway (ILMA) versus direct laryngoscope (DLS). Methods A total of 120 hypertensive patients undergoing abdominal surgery were randomly divided into 2 groups, i. e. intubating laryngeal mask airway (Group I ) and direct laryngoscope (Group D ). Variations of invasive arterial blood pressure and angiotensin Ⅱ were compared between two groups before and after intubation. Results The variations of cardiovascular responses and vascular angiotensin Ⅱ ( Ang Ⅱ) during tracheal intubation used of ILMA (T4) and DLS (T4) in an instant, tracheal intubation were immediately accomplished in two groups (T5). The variations of group I were significantly lower than those of group D ( P 〈 0. 05 ) . And statistical significance existed between two groups. Conclusion Tracheal intubation with intubating laryngeal mask airway (ILMA) can significantly reduce violent cardiovascular reactions and avoid cardiovascular accidents.
出处 《中华医学杂志》 CAS CSCD 北大核心 2013年第31期2467-2469,共3页 National Medical Journal of China
基金 福建省泉州市卫生局科研课题(2008006)
关键词 插管型喉罩 气管内插管 高血压 血管紧张素Ⅱ Intubating laryngeal mask airway Tracheal intubation Hypertension Vascular angiotensin Ⅱ
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共引文献53

同被引文献129

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