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目的:比较老年患者可视喉镜与普通喉镜下行气管插管对血流动力学和应激反应的影响。方法:回顾性纳入2020年1月至12月郑州大学第五附属医院收治的行气管插管的老年患者156例，根据行气管插管的工具分为可视喉镜气管插管组和普通喉镜气管插管组，每组78例。比较两组患者一次性插管成功率、声门暴露时间、气管插管时间，比较两组患者麻醉诱导前(T0)、麻醉诱导后(T1)、插管后1 min(T2)、插管后5 min(T3)的血流动力学指标(收缩压、舒张压、心率)，比较两组患者T0、T2、T3时应激反应指标(肾上腺素、去甲肾上腺素)水平，比较两组患者气管插管损伤状况。结果:可视喉镜气管插管组患者一次性插管成功率(100%，78/78)高于普通喉镜气管插管组(87.18%，68/78)，n P<0.05。可视喉镜气管插管组患者声门暴露时间和气管插管时间均短于普通喉镜气管插管组(n P均<0.05)。T2时，普通喉镜气管插管组患者收缩压、舒张压和心率均高于可视喉镜气管插管组(n P均<0.05)。T2、T3时，普通喉镜气管插管组肾上腺素和去甲肾上腺素的水平均高于可视喉镜气管插管组(n P均<0.05)。可视喉镜气管插管组患者的气管插管损伤率(6.41%，4/78)低于普通喉镜气管插管组(16.67%，13/78)，n P<0.05。n 结论:老年患者可视喉镜下行气管插管可减轻插管对舌部、咽喉部及气管黏膜的刺激，提升一次性气管插管的成功率，缩短插管时间，降低对老年患者血流动力学和应激反应的影响，且气管插管损伤率低，安全性较高。“,”Objective:To compare the effects of endotracheal intubation under visual laryngoscope and general laryngoscope on hemodynamics and stress response in elderly patients.Methods:One hundred and fifty-six elderly patients with endotracheal intubation admitted to the Fifth Affiliated Hospital of Zhengzhou University from January to December 2020 were included retrospectively. According to the tools of endotracheal intubation, patients were divided into visual laryngoscope endotracheal intubation group and general laryngoscope endotracheal intubation group, with 78 cases in each group. The success rate of one-time intubation, glottis exposure time and endotracheal intubation time were compared between the two groups. The hemodynamic indexes, including systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR), before anesthesia induction (T0), after anesthesia induction (T1), 1 min after intubation (T2) and 5 min after intubation (T3) were compared between the two groups. The levels of stress response indexes (epinephrine and norepinephrine) at T0, T2 and T3 were compared between the two groups. The endotracheal intubation injury was compared between the two groups.Results:The success rate of one-time intubation in the visual laryngoscope endotracheal intubation group (100%, 78/78) was higher than that in the general laryngoscope endotracheal intubation group (87.18%, 68/78), n P<0.05. The glottis exposure time and endotracheal intubation time in the visual laryngoscope endotracheal intubation group were shorter than those in the general laryngoscope endotracheal intubation group (alln P<0.05). At T2, SBP, DBP and HR in general laryngoscope endotracheal intubation group were higher than those in visual laryngoscope endotracheal intubation group (alln P<0.05). At T2 and T3, the levels of epinephrine and norepinephrine in the general laryngoscope endotracheal intubation group were higher than those in the visual laryngoscope endotracheal intubation group (alln P<0.05). The endotracheal intubation injury rate in visual laryngoscope endotracheal intubation group (6.41%, 4/78) was lower than that in general laryngoscope endotracheal intubation group (16.67%, 13/78),n P<0.05.n Conclusions:Endotracheal intubation under visual laryngoscope for elderly patients can significantly reduce the irritation of intubation on tongue, throat and tracheal mucosa, improve the success rate of disposable tracheal intubation, shorten intubation time, and reduce the great impact on hemodynamics and stress response of elderly patients. The injury rate of tracheal intubation is low and the safety is high.