丙泊酚在院外多发伤患者紧急气管插管中的临床应用(1)
[摘要] 目的 觀察丙泊酚在院外多发伤患者气管插管中的应用效果。 方法 回顾性分析2013年10月～2015年6月石家庄市急救中心194例院外出诊中急需气管插管的多发伤患者，按照麻醉方法不同分为三组。A组(65例)插管前给予丙泊酚静脉注射；B组(65例)插管前用2%盐酸利多卡因气管内表面麻醉；C组(64例)插管前给予地西泮静脉注射。记录插管准备时间、插管完成时间、咽部反射率、一次性插管成功率，以及用药前(T0)、插管时(T1)及插管后1 min(T2)、3 min(T3)、5 min(T4)的心率(HR)及血压(DBP、SBP)的变化情况。 结果 与B组相比，A组插管准备时间及插管完成时间缩短，一次性插管成功率提高，差异有统计学意义(P < 0.05)；与C组相比，A组插管准备时间及插管完成时间明显缩短，一次性插管成功率提高，插管后咽部反射率降低，差异有统计学意义(P < 0.05)。与T0时相比，T1时三组SBP、DBP、HR均下降，A组下降更为明显(P < 0.05)；T2时三组SBP、DBP、HR明显增加，B组增加更为明显(P < 0.05)。 结论 丙泊酚静脉注射可明显缩短气管插管准备时间、插管时间，提高插管成功率。三种药物都能抑制气管插管时心血管反应，但丙泊酚抑制气管插管时血流动力学变化的效果更佳。
[关键词] 丙泊酚；利多卡因；地西泮；院外急救；气管插管
[中图分类号] R614.2 [文献标识码] A [文章编号] 1673-7210(2017)09(a)-0069-04
[Abstract] Objective To observe the application effect of Propofol in emergency tracheal intubation of patients with multiple trauma outside the hospital. Methods 194 cases of patients with multiple trauma need emergency tracheal intubation outside the hospital in Shijiazhuang Emergency Center from October 2013 to June 2015 were analyzed retrospectively. According to the methods of anesthesia， patients were divided into three groups. 65 cases in group A were given intravenous injection of Propofol before intubation； 65 cases in group B were given 2% Lidocaine Hydrochloride intratracheal superficial anesthesia before intubation； 64 cases in group C were intravenous Diazepam before intubation. Intubation preparation time， intubation completion time， pharyngeal reflectivity， one-time intubation success rate were recorded. The heart rate (HR) and blood pressure [systolic blood pressure (SBP) and diastolic blood pressure (DBP)] at before drug use (T0)， endotracheal intubation immediately (T1)， 1 min after intubation (T2)， 3 min after intubation (T3)， 5 min after intubation (T4) were observed. Results Compared with group B， the intubation preparation time， intubation completion time were shorter and the one-time intubation success rate was higher in group A (P < 0.05). Compared with group C， the intubation preparation time， intubation completion time were shorter， the one-time intubation success rate was higher， and the pharyngeal reflectivity was lower in group A (P < 0.05). Compared with T0， in the three groups at T1 the HR， SBP and DBP decreased， and in group A the decreasing was significant (P < 0.05)； at T2 the HR， SBP and DBP of the three groups increased， and in group B the increasing was significant (P < 0.05). Conclusion Propofol intravenous injection can obviously shorten the intubation preparation time and intubation completion time， improve the success rate of intubation. Three kinds of drugs can suppress the cardiovascular response to tracheal intubation， but the effect of Propofol inhibits the changes of hemodynamic during endotracheal intubation is better., http://www.100md.com(李东旭 柳丽 狄才英)
[关键词] 丙泊酚；利多卡因；地西泮；院外急救；气管插管
[中图分类号] R614.2 [文献标识码] A [文章编号] 1673-7210(2017)09(a)-0069-04
[Abstract] Objective To observe the application effect of Propofol in emergency tracheal intubation of patients with multiple trauma outside the hospital. Methods 194 cases of patients with multiple trauma need emergency tracheal intubation outside the hospital in Shijiazhuang Emergency Center from October 2013 to June 2015 were analyzed retrospectively. According to the methods of anesthesia， patients were divided into three groups. 65 cases in group A were given intravenous injection of Propofol before intubation； 65 cases in group B were given 2% Lidocaine Hydrochloride intratracheal superficial anesthesia before intubation； 64 cases in group C were intravenous Diazepam before intubation. Intubation preparation time， intubation completion time， pharyngeal reflectivity， one-time intubation success rate were recorded. The heart rate (HR) and blood pressure [systolic blood pressure (SBP) and diastolic blood pressure (DBP)] at before drug use (T0)， endotracheal intubation immediately (T1)， 1 min after intubation (T2)， 3 min after intubation (T3)， 5 min after intubation (T4) were observed. Results Compared with group B， the intubation preparation time， intubation completion time were shorter and the one-time intubation success rate was higher in group A (P < 0.05). Compared with group C， the intubation preparation time， intubation completion time were shorter， the one-time intubation success rate was higher， and the pharyngeal reflectivity was lower in group A (P < 0.05). Compared with T0， in the three groups at T1 the HR， SBP and DBP decreased， and in group A the decreasing was significant (P < 0.05)； at T2 the HR， SBP and DBP of the three groups increased， and in group B the increasing was significant (P < 0.05). Conclusion Propofol intravenous injection can obviously shorten the intubation preparation time and intubation completion time， improve the success rate of intubation. Three kinds of drugs can suppress the cardiovascular response to tracheal intubation， but the effect of Propofol inhibits the changes of hemodynamic during endotracheal intubation is better., http://www.100md.com(李东旭 柳丽 狄才英)