食管引流型喉面罩对全麻腹腔镜卵巢囊肿剥除术麻醉质量的影响  

The influence of proseal laryngeal mask airway on general anesthesia in laparoscopic ovarioneas operation

作　　者：崔华庆[1] 

机构地区：[1]胜利石油管理局胜利医院,山东东营257055

出　　处：《腹腔镜外科杂志》2008年第2期108-110,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨食管引流型喉面罩在全麻腹腔镜卵巢囊肿剥除术中对麻醉质量的影响。方法:选择全麻腹腔镜卵巢囊肿手术患者90例,ASAⅠ级,随机分为插管组(n=45)和喉面罩组(n=45)。监测两组患者诱导插管前(T0)、诱导插管时(T1)、气腹时(T2)、苏醒拔管时(T3)、苏醒拔管后20min(T4)的平均动脉血压(MAP)、心率(HR)、血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)等变化,并于上述各时点抽取动脉血检测术中血气分析变化,观察患者围手术期呼吸系统等并发症的发生情况。结果:(1)术中SpO2、PETCO2无显著性差异(P>0.05);(2)两组T1、T2时MAP与T0比较均显著性降低(P<0.05),组间无显著性差异(P>0.05);插管组T3、T4时与T0比较MAP显著性升高(P<0.05),喉面罩组无显著性差异(P>0.05);(3)两组HR于T1、T2、T3、T4时与T0比较均显著性升高(P<0.05),T1、T3时插管组高于喉面罩组(P<0.05);(4)两组患者T2时与T1、T3比较,PETCO2、气道压力(Paw)略有升高,喉面罩组高于插管组(P>0.05);(5)喉面罩组T3时pH、PCO2与T0及插管组比较,略有升高,但无显著性差异(P>0.05);(6)术后插管组咽喉痛、声音嘶哑、咳嗽等情况的发生率高于喉面罩组(P<0.05)。结论:食管引流型喉面罩在全麻腹腔镜卵巢囊肿切除术中可提高围手术期麻醉质量,患者血流动力学稳定,围手术期并发症少,比较适合在全麻妇科腹腔镜短小手术中应用。Objective ： To investigate the influence of proseal laryngeal mask airway on general anethesia in laparoscopic ovarioneas operations. Methods：Ninety ASA- Ⅰ patients undergone laparoscopic ovarioneas operations were randonly assigned to proseal laryngeal mask airway（PLMA） （ n = 45 ） group and endotracheal intubation （ n = 45 ） group. Mean arterial pressure （MAP） , heart rate （HR） , saturation of blood oxygen （SpO2 ） , artrial partial pressure of carbon dioxide （PET CO2 ） and the change of blood-gas analysis were recorded before endotracheal intubation（ T0 ）, in endotracheal intubation（ T1 ）, in opeation time（ T2 ）, in extubation（ T3 ）, twenty roinutes after extubation （ T4 ）. Results ： （ 1 ） There were no significant differences in SpO2 and PE T CO2 in opertions （ P 〉 0.05 ） ; （ 2 ） Changes of MAP in two groups in endotracheal intubation and in operation time were significantly lower than those before endotradeal intubation（P 〈 0.05 ）. There were no significant differences between two groups（ P 〉 0.05 ） ;change of MAP in PLMA group in extubation and two minutes after extubation were higher than that before endotradeal intubation（P 〈 0.05 ）, but they are similar in endotradeal intubation group（ P 〉 0.05） ; （3） HR（ T1 -T4 ） were much higher than those of To （ P 〈 0.05 ）, HR in T1 and T3 in endotradeal intubation group were higher than those of the other group（ P 〈 0.05 ） ;（4）PETCO2 and Paw in T2 were a littler higher than those in T1 and T3;（5） pH and PCO2 in T3 in PI,MA group were higher than those in TO in PLMA group and those in the other group,but there were no significant differences （ P 〉 0.05 ） ; （6） The incidence of complications in PLMA group was lower than those of the other group （ P 〈 0.05 ）. Conclusions：PLMA enhances the quality of anesthesia in laparoscopic ovarioneas operations;it＇s stable and safe especially in small and short laparoscopy.

关 键 词：喉面罩 全麻 腹腔镜术 妇科手术 

分 类 号：R614[医药卫生—麻醉学]