高血压病老年患者麻醉应用气管插管或新型喉罩置入的血液动力学反应

Hemodynamic responses in geriatric patients with hypertension associated with insertion of endotracheal tube or streamlined pharynx airway liner

关键词:  新型喉罩  气管插管  老年病人  高血压病  血液动力学

Key words:  streamlined liner pharynx airway(SLIPA)  endotracheal tube  geriatric patient  hypertension  haemodynamics

摘要:

［目的］观察比较新型喉罩（SLIPA）与气管插管用于老年合并高血压病患者手术麻醉建立气道时血液动力学的反应。［方法］术前高血压诊断明确并经过系统治疗的老年患者，行择期手术共70例，随机分为两组：A组为气管插管组，B组为SLIPA组，记录在全麻后建立气道时两组血液动力学变化，结果进行统计学分析。［结果］建立气道后A组收缩压、舒张压、心率变化明显，插管后与插管时的比较差异有显著性意义（P<0.05）；B组血液动力学也有变化，但插管后与插管时的收缩压、舒张压、心率降低组内比较差异无显著性意义（P>0.05）；A、B两组组间插管后1 min、3 min内收缩压、舒张压、心率组间比较差异有显著性意义（P<0.05），5 min收缩压、舒张压、心率组间比较无显著性意义（P>0.05）。［结论］麻醉气道的建立应用新型喉罩SLIPA对于合并高血压病老年患者的血液动力学变化影响较小。

Abstract:

［Objective］SLIPATM is a new generation supralaryngeal airway that provides an alternative to facemask,laryngeal mask airway (LMA) and endotracheal tube.We designed this study to compare the hemodynamic responses of geriatric patients with hypertension during inserting the SLIPATM or intubation.［Methods］This was a single-blind,randomized and controlled study.Totally 70 geriatric patients with hypertension undergoing selective non-cardiac surgeries were recruited and randomly allocated into two groups:A) intubation and B) SLIPATM.All the patients were provided routine induction and maintenance of anesthesia.Vital signs including systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) were recorded before and 1st minute,3rd minute and 5th minute after inserting SLIPATM or intubation.Student's t-test was used to analyze the data of inter-and inner-group.［Results］Significant difference was found in group A before and after intubation (P<0.05),while no difference was found in group B.Vital signs in group A at 1st minute and 3rd minute after manipulation changed much more than those in group B and significant difference existed between two groups,difference was not found at 5th minute after manipulation between two groups.［Conclusion］The hemodynamic responses of geriatric patients with hypertension were less after inserting SLIPATM