急救中光棒法与直接喉镜法气管插管引发心血管反应的比较

目的:比较光棒法与直接喉镜法气管插管对心血管系统的影响,探讨光棒在临床急救领域的适用性。方法:选取我院急诊科室进行抢救的80名患者,随机分为两组,分别采用光棒法和直接喉镜法进行气管插管。记录插管所需时间、一次插管成功次数,以及插管前、插管时、插管后1分钟、插管后3分钟患者的收缩压、舒张压、平均动脉压、心率和血氧饱和度的变化情况。数据分析使用使用检验、t检验秩和检验、重复测量方差分析。结果:两组间性别、年龄、身高、体重、ASA、Mallampati评分差异无统计学意义,具备可比性。光棒组平均插管时间少于喉镜组(光棒:31.23 9.94秒,喉镜:48.15 8.67秒),一次插管成功率(97.5%)也高于喉镜组(80.0%)。经重复测量方差分析结果显示,光棒组各时点的收缩压(F=38.312,P=0.000)、舒张压(F=219.692,P=0.000)、平均动脉压(F=54.739,P=0.000)、心率(F=195.161,P=0.000)的整体趋势要低于与喉镜组。血氧饱和度(F=0.020,P=0.889)在两组间差异无统计学意义。结论:在气管插管过程中,光棒法比直接喉镜法引发的心血管系统变化更小,而且插管所需时间更短、一次成功率更高,是一种值得在急诊科室推广的气管插管技术。

Comparison of the Cardiovascular Response between Lightwand and Direct Laryngoscope Tracheal Intubation in Emergency Treatment

Objective: To study the feasibility of lightwand tracheal intubation in emergency process,compare the cardiovascular response between lightwand and direct laryngoscope tracheal intubation.Methods: 80 patients getting emergency treatment were randomly classified into lightwand or laryngoscope group.We recorded intubation time,success rate of first intubation,SBP,DBP,MAP,HR and SPO2 at period of "before intubation","during intubation","after intubation 1min " and "after intubation 3mins" for 2 groups.Results: Contrast to laryngoscope,lightwand completed tracheal intubation with shorter time(lightwand: 31.23 9.94s,laryngoscope: 48.15 8.67s) and better success rate in the first intubation(lightwand: 97.5%,laryngoscope:80.0%).The result of repeated measurement variance anal-ysis showed that the tendency of SBP,DBP,MAP and HR at different period was lower among lightwand group,compared with laryngo-scope group.Conclusion: During tracheal intubation process,contrast to laryngoscope tracheal intubation,lightwand induced less cardio-vascular response and were associated with better intubation time and success rate.Thus,it was a suitable technology to be used in Emer-gency setting.