光棒和直接喉镜引导下气管插管麻醉对老年择期手术患者血液动力学的影响

目的：评估光棒和直接喉镜引导下气管插管麻醉对老年择期手术患者血液动力学的影响。方法将170例于2011年10月-2013年10月在我院进行手术的老年患者随机分为光棒组和直接喉镜组。分别对两组患者麻醉各时间点（T0、T1、T2、T3）血液动力学指标、应激激素水平以及并发症进行比较。结果光棒组患者在麻醉过程中血液动力学指标和应激激素水平波动明显低于喉镜组（P＜0.05），光棒组一次插管成功率明显高于喉镜组（P＜0.05），插管时间明显短于喉镜组（P＜0.05）；光棒组的口腔损伤、咽喉痛、声音嘶哑等术后并发症发生率明显低于喉镜组（P＜0.05）。结论与直接喉镜引导插管麻醉相比，采用光棒引导插管一次性插管成功率高，患者血液动力学更为稳定，机体应激反应弱，术后并发症少，值得临床使用。

Inlfuence of Intratracheal Intubation Anesthesia Guided with Light Wand and Direct Laryngoscope on the Hemodynamics in Selective Operations of Elderly Patients

Objective To evaluate the inlfuence of intratracheal intubation anesthesia guided with light wand and direct laryngoscope on the hemodynamics in selective operations of elderly patients.Methods 170 elderly patients who would undergo selective operations from October 2011 to October 2013 in our hospital were randomly divided into light wand group （n=85） and direct laryngoscope group （n=85）. Hemorheology indexs and stress hormone levels of the patients in two groups were recorded at T0 （before anesthesia induction）, T1 （after anesthesia induction）, T2 （immediately after intubation） and T3 （1 min after intubation）. The incidence rates of various complications in two groups were also analyzed and compared.Results The fluctuation of hemorheology indexes and stress hormone levels of light wand group were signiifcantly lower than that of laryngoscope group （P〈0.05）. The once intubation success rate in light wand group was signiifcantly higher than that of laryngoscope group （P〈0.05）. The intubation time of light wand group was signiifcantly shorter than that of laryngoscope group （P〈0.05）. The incidence rates of various complications of light wand group were signiifcantly lower than those of laryngoscope group （P〈0.05）.Conclusion Compared with intratracheal intubation anesthesia guided by direct laryngoscope, intratracheal intubation anesthesia guided by light wand with higher once intubation success rate, more stable hemodynamics, weaker stress response and fewer complications was worth to be promoted in clinic.