LMA在颅内动脉瘤血管介入治疗术麻醉中应用的可行性研究  

The feasibility and security of LMA during general anesthesia for the operation of endovascular embolization in intracranial aneurysms

作　　者：刘英志[1] 宋力[1] 刘勇波[1] 王世端[1] 孟庆海[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003

出　　处：《山东医药》2005年第11期6-7,共2页Shandong Medical Journal

摘　　要：目的探讨喉罩置入通气(LMA)在颅内动脉瘤血管内介入治疗术麻醉中应用的可行性和安全性。方法将32例颅内动脉瘤患者随机分成两组,各16例。全身麻醉诱导后,喉罩通气组(LMA组)置入普通喉罩, 插管组(ETT组)行气管内插管。两组均行控制呼吸。分别在麻醉前(T6)、气管插管(置入喉罩)前(T1),插管后1 (T)、3(T3)、5(T4)、10(T5)分钟及手术结束时(T6)监测血压(Bp)、心率(HR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)、气道内峰值压力(Peak),手术前、后行动脉血气分析。结果ETT组在T2、T3、T4时点的Bp、HR比T0、T1时明显升高(P均<0.05),且明显高于同时点LMA组(P均<0.05),其他时点无显著差异。两组SpO2、PETCO2、Peak各时点无显著差异。结论在颅内动脉瘤介入治疗术麻醉中行LMA,可减轻气管插管引起的插管反应,降低动脉瘤破裂危险性,且通气功能维持良好。Objective To evaluate the feasibility and security of laryngeal mask airway (LMA)during general anesthesia for the operation of endovascular embolization in intracranial aneurysms. Methods 32 cases of intracrantal aneurysm were randomly into two groups. The patients in LMA group (n=16) were conducted of LMA insertion,while those in ETT group were performed endotracheal mtubation(ETT)with tracheal tube after induction of anesthesia. All the patients were performed controlled-ventilation. Blood pressure (Bp), Heart rate (HR),Pulse Oxygen saturation (SpO2), End-tidal Carbon dioxide tension(PETCO2),airway peak pressure (Peak) and blood-gas were monitored at seven time points:before induction of anesthesia(T0),before insertion (T1),1 min(T2),3min(T3),5 min(T4),10 after insertion(T5)and the end of operation(T6). Results The Bp.HR at T2, T3,T4 time points in ETT group increased significantly than that of T0,T1 time point(P<0.05),and higher than that in LMA group(P<0. 05). SpO2,PETCO2,Peak and blood-gas at the same time point were similar between the two groups. Conclusion LMA during general anesthesia for this kind of operation can induce less intubation reaction,reduce the rupture of intracranial aneurysms and maintain a good function of ventilation.

关 键 词：介入治疗术 LMA 瘤血管 呼气末二氧化碳分压 颅内动脉瘤 脉搏血氧饱和度 全身麻醉诱导 心率(HR) 动脉血气分析 PETCO2 气管插管 气管内插管 动脉瘤破裂 喉罩置入 喉罩通气 控制呼吸 监测血压 手术结束 SpO2 插管反应 通气功能 

分 类 号：R473.72[医药卫生—护理学] R473.5[医药卫生—临床医学]