两种麻醉诱导气管插管对危重患者心血管应激反应的影响比较.docVIP

精品论文 参考文献 两种麻醉诱导气管插管对危重患者心血管应激反应的影响比较 邓崇亮 　　广西恭城瑶族自治县人民医院麻醉科 542500 　　【摘 要】目的：通过分析比较两种麻醉诱导气管插管方式对危重患者心血管应激反应的影响，选择临床上更为安全有效的方法。方法：选择我院2014年6月-2015年8月的60例危重患者，随机分组，观察组33例，对照组27例。观察组患者气管插管时选用氯胺酮、异丙酚、芬太尼、维库溴铵进行麻醉诱导，对照组患者选用咪唑安定、异丙酚、芬太尼、维库溴铵进行麻醉诱导气管插管。比较两组患者所得疗效以及在进行插管前后患者的血流动力学变化情况。结果：两组患者经过麻醉诱导后插管前出现不同程度的血压、心率下降，相比于诱导前有统计学意义（P＜0.05）。对照组患者相比于观察组在插管后出现血压、心率显著升高现象，有统计学意义（P＜0.05）。结论：选择氯胺酮联合异丙酚、芬太尼、库溴铵进行气管插管前的麻醉诱导，是较为安全可靠的麻醉诱导方法。 　　【关键词】麻醉诱导；气管插管；心血管应激反应 　　[Abstract] Objective：through the analysis of the comparison of two anesthesia induction tracheal intubation of critically ill patients with cardiovascular stress response，selected for clinical safe and effective methods. Methods：our hospital in June 2014 and 2015 August 60 cases of critically ill patients were randomly divided into 3 groups，observation group（33 cases），27 cases of the control group. Observation group patients with tracheal intubation used ketamine，propofol，fentanyl and vecuronium bromide induction of anesthesia，patients in the control group used midazolam，propofol，fentanyl and vecuronium bromide anesthesia induction and tracheal intubation. The income effect of the patients in both groups were compared and the intubation in patients before and after blood flow Mechanical changes. Results：two groups of patients after anesthesia induction and intubation after appeared different degree of blood pressure，heart rate decreased，compared to before induction have statistical significance（P lt; 0.05）. Patients in the control group compared to the observation group after intubation in blood pressure，heart rate was significantly increased，statistical significance（P lt; 0.05）. Conclusion：the effect of ketamine combined with propofol，fentanyl，rocuronium were tracheal intubation before induction of anesthesia is more safe and reliable approach to induction of anesthesia. 　　[Keywords] induction of anesthesia；tracheal intubation；cardiovascular stress response 　　临床上在进行麻醉诱导气管插管时极易发生麻醉意外，导致意外发生的主要原因在于治疗过程中患者血流动力学的波动过于剧烈。而对