摘要
目的观察不同头位对帝视内镜经口气管插管的影响。方法选取行择期手术的患者40例,随机分入标准头位组(标准组)和修正头位组(修正组),每组20例。所有患者在全身麻醉后于帝视内镜引导下行气管插管,分别于麻醉诱导前(T0)、气管插管前(T_1)、插管成功即刻(T_2)和插管后3min(T_3)各时间点,记录患者的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)和气管插管操作时间。结果两组间患者的甲颏距离、张口度、头后仰度的差异均无统计学意义(P值均>0.05)。两组T_1时间点的MAP均显著低于同组T_0时间点(P值均<0.05),T_1至T_3时间点的SpO2均显著高于同组T0时间点(P值均<0.05);T_1至T_3时间点的HR与同组T0时间点的差异均无统计学意义(P值均>0.05)。两组间各时间点MAP、HR和S_pO_2的差异均无统计学意义(P值均>0.05)。标准组气管插管操作时间为(100.13±23.67)s,显著长于修正组的(76.36±9.22)s(P<0.05)。结论不同头位行帝视内镜经口气管插管对患者的血流动力学均无明显影响。与标准头位相比,修正头位的气管插管操作时间明显缩短。
Objective To observe the influence of different head positions on Disposcope guided tracheal intubation. Methods Forty patients undergoing selective operation under general anesthesia were enrolled in this prospective study. The patients were randomly allocated to standard head position group and corrected head position group （n = 20）. After anesthesia induction, tracheal intubation was performed under the guidance of Disposcope. Mean arterial pressure （MAP）, heart rate （HR） and pulse oxygen saturation （SpO2） were recorded at the following time points： before anesthesia （T0）, before intubation （T1）, immediately after intubation （T2）, and 3 minutes after intubation （T3）. Operation time of tracheal intubation was also recorded. Results There were no significant differences in the baseline data between the two groups, including mouth opening, thyromental distance, and neck movement （all P〉0.05）. Compared with those at To, MAP at T1 were significantly decreased （both P〈0.05）, while SpO2 at T1 -T3 were significantly increased in both groups （all P〈0.05）. HR at T1 -T3 were not significantly different from that at To （all P〉 0. 05） in the same group. There were no significant differences in terms of MAP, HR or SpO2 between the two groups at each time point （all P〉0.05）. The operation time of tracheal intubation in standard head position group was significantly longer than that in corrected head position group （[100. 13 - 23. 67] s vs. [76.36 ± 9. 22] s, P〈0, 05）. Conclusion Hemodynamic responses are similar during tracheal intubation under the guidance of Disposcope at different head positions. Compared with standard head position, the operation time of tracheal intubation at corrected head position is significantly shortened. （Shanghai Med J, 2016, 39： 353-355）
出处
《上海医学》
CAS
CSCD
北大核心
2016年第6期353-355,I0001,共4页
Shanghai Medical Journal
