摘要
目的观察喉罩与传统气管内插管麻醉用于妇科腹腔镜手术的安全性、可行性。方法择期妇科腹腔镜手术患者40例,年龄21～63岁,ASAⅠ～Ⅱ级,随机分为喉罩组(PLMA)组和气管导管(TT)组,每组20例,麻醉后记录心率(HR)、平均动脉压(AMP)、气道峰压(Ppeak)、潮气量(VT)脉博血氧饱合度(SPO2)、呼吸末二氧化碳分压(PETCO2)、插、拔管期、术后24小时相关并发症。结果(1)HR、AMP变化;PLMA组插管时、插管后5min、拔管时、拔管后5min较TT组降低,(P<0.05或0.01)。(2)两组PETCO2、Ppeak、VT;插管后间歇正压通气20min时和气腹20min时差异无统计学意义(P>0.05)。两组血氧一直保持稳定水平。(3)两组并发症比较:拔管时TT组60%出现呛咳或挣扎反应,术后2、24h咽痛发生率分别为22%、25%,而PLMA组均无拔管反应和术后咽痛。(4)手术医师对手术条件的评价100%满意。结论喉罩与气管导管相比,操作简便、应激反应小,通气可靠,避免了术后咽喉部并发症的发生。
Objective To observe the safety and feasibility of laryngeal mask airway and endotracheal intubation anesthesia used for laparoscopic gynecology operation. Methods Forty ASA Ⅰ or Ⅱ patients aged 21-63 yr undergoing selective laproscopic gynecology operation were randomly assigned to laryngeal mask airway（PLMA n=20）group and endotracheal intuhation（TT n=20） group. Heart rate （HR）, mean arterial pressure（MAP）, airway peak pressure（P peak）, tidal volume（Vr）, saturation of blood oxygen （Spo2）, arterial partial pressure of carbon dioxide （PETCO2）, compieatons that occurred in endotracheal intubation 24 hours postoperatively were recorded. Results （1） Changes of HR and MAP The changes of HR and MAP in PLMA group were lower than that of TP group in endotracheal iatubation, five minutes after endotmchcal intubation, extubation, five minutes after extuhation. （P〈0.05 or 0.01）. （2）Changes of PETCO2. Ppcak, Vr： The changes of PET CO2, Ppeak, Vr were not different statistically in 20 minutes possitive pressure ventilation after endotrachcal intubion and 20 minutes deflation （P〉 0.05）. （3）The complications of two greups：60% of patients in TT group occurred choking or struggeling reaction during extubation, the rate of pharynx sore occurence were 22% and 25% respectively during 2 hours and 24 hours postoperatively, there were no extubation waetion and pharynx sore in PLMA group. （4） The surgeons were sotisfactied perfectly with condition of surgery. Conclusions Compared with endotracheal intubation, laryn- geal mask airway was easy to use, the stress of patients was low, the ventilation was stable, it avoid the oecurence of complications of pharynxand laryngeal.
出处
《海南医学》
CAS
2006年第4期19-21,共3页
Hainan Medical Journal
作者简介
徐江玲（1959-06），女，四川省绵阳人．主治医师。
