不同全麻诱导方法对腹腔镜胆囊切除病人胃胀程度和呼吸的影响  

EFFECTS OF DIFFERENT GENERAL ANESTHESIA INDUCTION METHODS ON PATIENTS WITH GASTRIC DISTENSION AND RESPIRATION UNDER LAPAROSCOPIC CHOLECYSTECTOMY

作　　者：韩志强[1] 姚彤[1] 于建设[1] 张瑞明[1] 

机构地区：[1]内蒙古医学院附属医院麻醉科,内蒙古呼和浩特010050

出　　处：《内蒙古医学院学报》2009年第4期373-375,共3页Acta Academiae Medicinae Neimongol

基　　金：国家自然科学基金(30460131)

摘　　要：目的:探讨在腹腔镜手术中全麻诱导时保留自主呼吸诱导的方法对胃胀气及呼吸的影响。方法:60例拟在全麻下行腹腔镜胆囊切除术的病人。随机分为2组,每组30例。自主呼吸诱导组(实验组)入室后先行咽喉表面麻醉,全麻诱导采用保留呼吸无肌肉松弛药剂诱导;正压通气诱导组(对照组)全麻诱导常规使用去极化肌肉松弛药。观察两组病人术中胃的膨胀情况及诱导前后SaO2、血气值、终末潮气二氧化碳分压(PETCO2)。结果:实验组病人的胃的膨胀程度低于对照组(P<0.05),实验组病人诱导时的PaO2低于对照组(P<0.05),PETCO2、PaCO2高于对照组(P<0.05),但二者均在正常范围内。结论:在全麻下行腹腔镜胆囊切除术中,诱导时使用保留自主呼吸的方法可明显减轻术中胃的膨胀,避免病人术前留置胃管的恐惧及不适,同时对病人的血气无明显影响。Objective：To investigate the effects of the general anesthesia induction methods with spontaneously breathing on gastric distension and respiration in patients with laparoscopic cholecystectomy（LC）.Methods：Sixty patients were randomly divided into manual positive ventilation group（control group）and spontaneous ventilation group（test group）.The patients of test group were given throat surface anesthesia in advance and then were given general anesthesia induction with retaining spontaneously breathing.Depolarizing muscle relaxant was used in the control group routinely.Observing the gastric distension and blood gas values during the operation,SaO2,PETCO2 were recorded before and after the general anesthesia induction.Results：Gastric distension score in test group were significantly lower than that in control group（P〈0.05）.The PaO2 of test group were lower than that of control group（P〈0.05）,only during the induction period,although the PETCO2、PaCO2 in the test group were higher than that in control group,both within normal limits.Conclusion：General anesthesia induction methods of with spontaneously breathing can significantly relieve gastric distension and avoid the horror and indisposition of gastric tube before operation.There is little effects in blood gas.

关 键 词：腹腔镜胆囊切除术 全身麻醉 胃膨胀 呼吸 

分 类 号：R575.61[医药卫生—消化系统]