SLIPA喉罩通气全身麻醉在腹腔镜胆囊切除术中的应用  

Application of SLIPA under general anesthesia during laparoscopic cholecystectomy

作　　者：吴文玉[1] 汤安俊 王仁军[1] 

机构地区：[1]江苏省镇江市第二人民医院,江苏镇江212002

出　　处：《中国内镜杂志》2011年第1期20-23,共4页China Journal of Endoscopy

摘　　要：目的探讨SLIPA喉罩通气全身麻醉在腹腔镜胆囊切除术中临床应用的可行性和安全性。方法 120例行腹腔镜胆囊切除术患者,随机分成两组:SLIPA喉罩组(SLIPA组,60例)和气管插管组(TT组,60例)。人工气腹后SLIPA喉罩组选择相对低潮气量和较快的呼吸频率进行机械通气,TT组常规机械通气。监测平均动脉压(MAP)、脉搏氧饱和度(SPO2)、心率(HR)、气道峰压(Ppeak)、肺顺应性(Compl)、呼气末二氧化碳分压(PetCO2)。观察有无反流误吸情况,记录拔管(喉罩)时躁动、呛咳、咽喉痛、声音嘶哑、喉罩或气管导管沾染血迹等发生情况。结果 SLIPA组喉罩置入成功率98.33%,气腹后相对低潮气量和较快呼吸频率通气未发生低氧血症和二氧化碳蓄积,各监测时间点SPO2、PetCO2均在正常范围,两组间差异无显著性(P>0.05)。气管插管(喉罩)和拔管(喉罩)时,TT组MAP增高、HR加快变化明显(P<0.05),而SLIPA组则较为平稳(P>0.05)。SLIPA组躁动、呛咳、咽喉痛、声音嘶哑、喉罩或气管导管沾染血迹等发生率也低于TT组(P<0.05)。结论 SLIPA喉罩通气全身麻醉用于腹腔镜胆囊切除术,可减轻插管时对咽喉及气道的刺激,维持血流动力学相对稳定,确保气道通畅和有效通气。【Objective】To discuss the feasibility and security of SLPA under general anesthesia during laparo-scopic cholecystectomy.【Methods】One hundred and twenty patients with laparoscopic cholecystectomy were ran-domly assigned to SLIPA group and endotracheal intubation（TT） group.After pneumoperitoneum,mechanical venti-lation model is low tidal volume and faster respiratory rate in SLIPA.Conventional mechanical ventilation in TT group.Map,SPO2,HR,Ppeak,Compl and PetCO2 were recorded.countercurrent mistake inhalation was observed.Agitation,cough,sore throat,hoarseness and bloodstain on catheter were recorded.【Results】Success rate of im-plantation in SLIPA group is 98.33%,SPO2,PetCO2 were all normal after pneumoperitoneum,There were no signifi-cant difference between two groups（P 0.05）.MAP and HR increased greatly when catheter implanting and pulling out（P 0.05）.The incidence of agitation,cough,sore throat,hoarseness and bloodstain on catheter in SLIPA group was significant lower than that in TT group（P 0.05）.【Conclusions】SLIPA with general anesthesia can be safely used during laparoscopic cholecystectomy.It can reduce the catheter stimulation to the throat and airway,maintain stable hemodynamics,insure the clear airway and effective ventilation.

关 键 词：SLIPA喉罩 腹腔镜 胆囊切除术 

分 类 号：R614.24[医药卫生—麻醉学] R657.4[医药卫生—外科学]