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| 气管插管与喉罩对非颅脑手术患者视神经鞘直径影响的比较 |
| Comparison of optic nerve sheath diameter change between endotracheal intubation and laryngeal mask airway |
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| DOI：10.12089/jca.2019.11.011 |
| 中文关键词: 视神经鞘直径 颅内压 气管插管 喉罩 超声 |
| 英文关键词: Optic nerve sheath diameter Intracranial pressure Endotracheal intubation Laryngeal mask airway Ultrasonography |
| 基金项目:国家自然科学基金(81771142,81870875);江苏省医学重点学科(ZDXKA2016018);江苏省青年医学人才(QNRC2016014);江苏省“六大人才高峰”(YY-077,YY-084) |
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| 中文摘要: |
目的 应用经眼眶超声测量视神经鞘直径(ONSD),比较气管插管与喉罩对全麻非颅脑手术患者ONSD的影响。
方法选择全身麻醉下行择期非颅脑手术患者45例,男26例,女19例,年龄18～80岁,随机分为三组:气管插管组(A组),气管内表麻+气管插管组(B组)和喉罩组(C组)。分别在麻醉诱导前5 min(T0)、插入气管导管或喉罩前(T1)和插入气管导管或喉罩后1 min(T2)、5 min(T3)、10 min(T4),应用床旁超声经眼眶测量眼球后3 mm处ONSD,并随访术后头痛、头晕、恶心呕吐的发生情况。
结果 与T0时比较,T2—T3时A组双侧ONSD均明显增加,且明显大于B组和C组(P<0.05);B组和C组双侧ONSD变化差异无统计学意义。三组患者在术后24 h内无一例头痛,头晕、PONV发生率差异无统计学意义。
结论 喉罩置入对ONSD的影响较气管插管小,气管内表麻可以减轻气管插管引起的ONSD升高。 |
| 英文摘要: |
Ojective To compare the change of optic nerve sheath diameter (ONSD) in patients receiving endotracheal intubation or laryngeal mask airway (LMA) under transorbital ultrasound undergoing selective non-craniocerebral surgery under general anesthesia.
Methods Forty-five patients, 26 males and 19 females, aged 18-65 years, scheduled for selective non-craniocerebral surgery under general anesthesia, were randomly divided into 3 groups: endotracheal intubation group (group A), intratracheal surface anesthesia+endotracheal intubation group (group B) and laryngeal mask airway (LMA) group (group C). The ONSD was measured 3 mm behind the globe in an axis perpendicular to the optic nerve using bedside transorbital ultrasound at 5 min before anesthesia induction (T0), before intubation (T1) and at 1 min (T2), 5 min (T3), 10 min (T4) after intubation. The occurrence of postoperative headache, dizziness, nausea and vomiting was also observed.
Results The ONSD of group A at T2 and T3 was significantly increased after endotracheal intubation as compared with T0, and group B, group C (P<0.05). There was no significant difference in the ONSD between group B and group C. There was no significant difference in the occurrence of postoperative headache, dizziness, nausea and vomiting among the three groups.
Conclusion LMA has little effect on ONSD as compared with endotracheal intubation. Endotracheal surface anesthesia can alleviate the increase of ONSD caused by endotracheal intubation. |
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