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时间:2020-05-01
《Supreme喉罩与气管插管对老年高血压患者人工膝关节置换术应激反应的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、临床麻醉学杂志2014年6月第3O卷第6期JClinAnesthesiol,June2014,Vo1.30,No.6.临床研究.Supreme喉罩与气管插管对老年高血压患者人工膝关节置换术应激反应的影响张海山王大龙左振芳葛维鹏王中伟郑观荣刘克王帅【摘要】目的探讨Supreme喉罩(SIMA)和气管插管对老年高血压患者人工膝关节置换术应激反应的影响。方法选择择期老年高血压人工膝关节置换术患者4O例,ASA工~Ⅲ级,采用随机数字表法,将患者均分为喉罩组(LMA组)和气管插管组(TT组)。采用相同的麻醉诱导和维持方法,患者入室后连续无创监测Sp02和ECG变化,连续监测S
2、BP、DBP、HR,分别记录两组麻醉诱导前(To,基础值)、插管(喉罩)后即刻(T)、5min(T2)、15min(Ts)时SBP、DBP、HR及血清皮质醇(Cor)、心钠素(ANP)含量、血浆肾上腺素(E)和去甲肾上腺素(NE)浓度。结果与T0时比较,T1~T3时IMA组患者SBP、DBP明显降低(P3、T组E、NE浓度和Cor含量明显升高,且明显高于LMA组(P4、ithkneearthroplastyZHANG月ai-shan·WANGDa·long.ZUOZhen-fang,GEWei—pP,WANGZhong-wei,ZHENGGuan—rong,L【,Ke,WANGShuai.Depart-mentofAnesthesiology,ShengliOilfieldCentralHospital,Dongying257034,ChinaCorrespondingauthor:WANGDa-long,Email:16719077@qq.com[Abstract]ObjectiveToinvestigatetheeffects5、ofsupremelaryngealmaskairway(SLMA)andendotrachealintubationontheelderlyhypertensivepatientstreatedwithkneearthroplasty.MethodsFortycasesofelderlyhypertensivepatientsASAI一11treatedwithkneearthroplastyinourhospitalwereselectedandrandomlydividedintolaryngealmaskairwaygroup(groupLMA)andend6、otrachealintubation(groupTT),20casesforeachgroup.Thesameprotocolforinductionandmaintenanceofgeneralanesthesiawasused.Afterthepatientsentering,thechangesofSp02andECGwereperformedcontinuousnoninvasivemonitoringandSBP.DBPandHRwereperformedcon—tinuousinvasivemonitoring.SBP,DBPandHRoftwogro7、upswererecordedatdifferenttimepoints:beforeanesthesiainduction(]r0,basedvalue),atintubationimmediate(T1),5minsafterintubation(Tz)and15minsafterintubation(T3).Atthesametime,thecontentofcortisol(Cor),atrialnatri—ureticpeptide(ANP)andtheconcentrationofepinephrine(E)andnorepinephrine(NE)
3、T组E、NE浓度和Cor含量明显升高,且明显高于LMA组(P4、ithkneearthroplastyZHANG月ai-shan·WANGDa·long.ZUOZhen-fang,GEWei—pP,WANGZhong-wei,ZHENGGuan—rong,L【,Ke,WANGShuai.Depart-mentofAnesthesiology,ShengliOilfieldCentralHospital,Dongying257034,ChinaCorrespondingauthor:WANGDa-long,Email:16719077@qq.com[Abstract]ObjectiveToinvestigatetheeffects5、ofsupremelaryngealmaskairway(SLMA)andendotrachealintubationontheelderlyhypertensivepatientstreatedwithkneearthroplasty.MethodsFortycasesofelderlyhypertensivepatientsASAI一11treatedwithkneearthroplastyinourhospitalwereselectedandrandomlydividedintolaryngealmaskairwaygroup(groupLMA)andend6、otrachealintubation(groupTT),20casesforeachgroup.Thesameprotocolforinductionandmaintenanceofgeneralanesthesiawasused.Afterthepatientsentering,thechangesofSp02andECGwereperformedcontinuousnoninvasivemonitoringandSBP.DBPandHRwereperformedcon—tinuousinvasivemonitoring.SBP,DBPandHRoftwogro7、upswererecordedatdifferenttimepoints:beforeanesthesiainduction(]r0,basedvalue),atintubationimmediate(T1),5minsafterintubation(Tz)and15minsafterintubation(T3).Atthesametime,thecontentofcortisol(Cor),atrialnatri—ureticpeptide(ANP)andtheconcentrationofepinephrine(E)andnorepinephrine(NE)
4、ithkneearthroplastyZHANG月ai-shan·WANGDa·long.ZUOZhen-fang,GEWei—pP,WANGZhong-wei,ZHENGGuan—rong,L【,Ke,WANGShuai.Depart-mentofAnesthesiology,ShengliOilfieldCentralHospital,Dongying257034,ChinaCorrespondingauthor:WANGDa-long,Email:16719077@qq.com[Abstract]ObjectiveToinvestigatetheeffects
5、ofsupremelaryngealmaskairway(SLMA)andendotrachealintubationontheelderlyhypertensivepatientstreatedwithkneearthroplasty.MethodsFortycasesofelderlyhypertensivepatientsASAI一11treatedwithkneearthroplastyinourhospitalwereselectedandrandomlydividedintolaryngealmaskairwaygroup(groupLMA)andend
6、otrachealintubation(groupTT),20casesforeachgroup.Thesameprotocolforinductionandmaintenanceofgeneralanesthesiawasused.Afterthepatientsentering,thechangesofSp02andECGwereperformedcontinuousnoninvasivemonitoringandSBP.DBPandHRwereperformedcon—tinuousinvasivemonitoring.SBP,DBPandHRoftwogro
7、upswererecordedatdifferenttimepoints:beforeanesthesiainduction(]r0,basedvalue),atintubationimmediate(T1),5minsafterintubation(Tz)and15minsafterintubation(T3).Atthesametime,thecontentofcortisol(Cor),atrialnatri—ureticpeptide(ANP)andtheconcentrationofepinephrine(E)andnorepinephrine(NE)
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