视频喉镜气管插管在妇科手术应激反应的研究.doc

GlideScope视频喉镜在妇科患者全身麻醉气管插管中的应用 松江区妇幼保健医院 张琳玲 罗文杰 李玉莲 陆其英 肖峰等 [摘要] 目的 探讨GlideScope视频喉镜在妇科全身麻醉手术患者气管插管中的应用价值。 方法 选择择期全身麻醉妇科手术患者120例,年龄22～60岁,ASA分级Ⅰ～Ⅱ级。随机分为2 组。GlideScope视频喉镜组(A组)60例，传统直接喉镜组(B组)60例。两组病人给予相同的诱导方法，并由同一个麻醉医师实施气管插管术。记录诱导前、诱导后、插管即刻和插管后1、2、3、4、5分钟,各时间点的循环指标(MAP、HR、ST段),计算两组气管插管的一次成功率以及术后24小时两组患者气管插管术的不良反应率。 结果 与B组比较,诱导后、插管时，以及插管后1、2、3、4、5分钟的循环指标的差异均无统计学意义,气管插管的一次成功率及不良反应率的差异有统计学意义,A组气管插管一次成功率100%，B组气管插管一次成功率87%，P0.05。A组气管插管术后24小时的不良反应发生率为6.8%，B组术后不良反应发生率为33.4%， P0.05。 结论: 对于接受全身麻醉的妇科手术患者而言，GlideScope视频喉镜能有效提高一次插管成功率和降低不良反应发生率。但也能够引起类似传统喉镜的一过性血压升高和心率增快反应。 关键词：GlideScope视频喉镜 直接喉镜 经口气管插管 血流动力学 Investigating the GlideScope video laryngoscope induced stress reactions of the gynecologic patients during general anesthesia Zhang Linlin, Luo Wenjie, Li Yuliang, Lu Qiying, Xiao Fen Women and Childern’s Hospital and Health Institute of Songjiang District, Shanghai China Abstract Objective To investigate the stress reaction induced by GlideScope video laryngoscope of the patients undergoing gynecologic surgeries during general anesthesia. Methods 120 women patients, ASA Ⅰ-Ⅱ, scheduled to the gynecologic surgeries with general anesthesia were randomly divided into two groups: the GlideScope video laryngoscope group (group A) and the traditional direct laryngoscope group (group B), 60 patients in each group. All patients were induced with the same protocol and their tracheal intubations were performed by the same anesthesiologist. The hemodynamic parameters such as MAP, HR and ST segment were recorded at the time points as before and after induction, immediately after, and 1, 2, 3, 4, 5 min after tracheal intubation, while, the first successful tracheal intubation rates and the adverse reaction rates of tracheal intubation were compared between the two groups. Results: The hemodynamic parameters at the time-points as after intubation, immediately, and 1,2,3,4,5 min after tracheal intubation of the patients in group A had no significantly difference when compared wi