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| 头抬高后仰位联合60°气管拔管对患者拔管期应激反应的影响 |
| Effect of the head elevation and hypsokinesis with the extractionangle of 60 degrees on the stress response in patients |
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| DOI： |
| 中文关键词: 抬高后仰 拔管 角度 力度 应激反应 |
| 英文关键词: Elevation and hypsokinesis Extraction Angle Force Stress response |
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| 中文摘要: |
| 目的：观察头抬高后仰位联合60°气管拔管对患者拔管期应激反应的影响。方法选择全麻下行大隐静脉高位结扎手术的患者90例,男33例,女57例,年龄18~40岁,体重45~75 kg, ASA Ⅰ或Ⅱ级。按照随机数字表法均分为三组,每组30例。A 组患者平卧位,气管导管拔管角度为90°(拔管方向与地面夹角呈90°),B 组患者平卧位,拔管角度为60°(拔管方向与地面夹角呈60°),C组患者头抬高后仰位,拔管角度为60°。记录手术结束时(T0)、拔管前1 min(T1)、拔管后1 min (T2)、5 min(T3)的 SBP、DBP 及 HR,记录拔管的力度,观察呛咳、咽痛、声音嘶哑发生情况。结果与T0时比较,T2时三组 SBP、DBP 明显升高,HR 明显增快(P <0.05),T3时 A、B 组 SBP、DBP明显升高,HR 明显增快(P <0.05)；T2、T3时 B、C 组 SBP、DBP 明显低于,HR 明显慢于,拔管力度明显小于 A 组(P <0.05)；T2、T3时 C 组 SBP、DBP 明显低于,HR 明显慢于,拔管力度明显小于 B组(P <0.05)。B、C 组呛咳发生率[3例(10.0%),2例(6.6%)]明显低于 A 组的[12例(40.0%)](P <0.05)。结论头抬高后仰位联合60°拔除气管导管能明显减轻患者拔管期应激反应。 |
| 英文摘要: |
| Objective To observe the effect of the head elevation and hypsokinesis with the ex-traction angle of 60°on the stress response in patients.Methods Ninety patients who were treated with the great saphenous vein high ligation surgery were divided into three groups according to the random number table method,with 30 in each group.Patients in group A with supine position,the angle of tracheal extubation was 90°(90°from the angle of the ground);patients in group B with su-pine position,the angle was 60°(60°from the angle of the ground);patients in group C with head selevation and hypsokinesis,the angle was 60°.SBP,DBP,HR and extubation force were recorded at the end of the operation (T0 ),1 minute before extubation (T1 ),1 minute after extubation (T2 ),5 minutes after extubation (T3 ), and the occurrence of bucking, sore throat, hoarseness were observed.Results The SBP,DBP,HR at T2 were significantly higher than those at T0 in all groups (P <0.05),while the SBP,DBP,HR at T3 were significantly higher than those at T0 in only groups A and B (P <0.05).The differences of those indicators between T3 and T0 had no statistical signifi-cance in group C.The SBP,DBP,HR at T2 ,T3 and the extubation force were significantly decreased in group B and group C compared with group A (P <0.05).Compared with group B,the SBP,DBP, HR at T2 ,T3 and the extubation force were significantly decreased in group C(P <0.05).The inci-dence of choking in group B [3 (10.0%)]and group C [2 (6.6%)]was significantly decreased than that in group A [12 cases(40.0%)](P < 0.05 ).Conclusion The head elevation and hypsokinesis with the extraction angle of 60°can significantly reduce stress reaction in patients during the extuba-tion. |
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