食管引流型喉罩在腹腔镜胆囊手术麻醉中的应用  

Application of Proseal Laryngeal Mask Airway for Ventilation in Laparoscopic Cholecystectomy

作　　者：王耀明[1] 朱跃坤[1] 王科[1] 王爱民[1] 陈永喜[1] 

机构地区：[1]苏州市吴中人民医院麻醉科,江苏苏州215128

出　　处：《中国血液流变学杂志》2011年第3期443-445,511,共4页Chinese Journal of Hemorheology

摘　　要：目的 探讨食管引流型喉罩（PLMA）在腹腔镜胆囊切除术中应用的有效性和安全性,为第三代喉罩应用于该类微创手术提供参考.方法 40例择期行腹腔镜胆囊切除手术患者,ASAⅠ～Ⅱ级,体重指数〈25kg/m2,随机分为气管导管组（T组）和食管引流型喉罩组（P组）,每组20例.P组常规放置胃管并测定气道密闭压.观察两组插管（罩）的成功率及操作时间,插拔管时血压、心率变化,气腹前后呼吸参数变化,术中术后并发症的发生情况.结果 两组插管时间相似,均无失败病例.P组较T组在插拔管时血流动力学变化小（P＜0.05）,术中术后并发症少.两组在气腹前后呼吸参数变化相似,组间比较无显著性差异;P组中平均气道密闭压大于气腹后平均吸气峰压（PIP）.结论 PLMA操作较简单,成功率高,通气与气管插管一样有效且血流动力学平稳,术中术后并发症更少,可安全地应用于非肥胖性腹腔镜胆囊切除术的患者.Objective To discuss the efficiency and safety of proseal laryngeal mask airway（PLMA） for ventilation during laparoscopic cholecystectomy, and to provide reference for further studying of PLMA in microinvasive surgery. Method Forty ASA I -II adult patients undergoing selective laparoscopic cholecystectomy were randomly divided into proseal laryngeal mask airway group（PLMA,n=20） and intratracheal intubation group（IT, n=20）.The airway seal pleasure was monitored using the nasogastric tube in PLMA group.In both groups,the successful rates and the operating time were compared.And the Bp, HR changes in intubation and extubation were measured.Effects of variations in CO2 pneumoperitoneum pressure on respiratory parameter variation were monitored.Also,complications in/after operations were compared in both groups. Results PLMA and tracheal intubation in two groups were inserted successfully, and the inserting-time was similar.The hemodynamics of PLMA group changed less than of IT group,and had more less complications in PLMA group. The respiratory parameter variation in both group had no significance.In PLMA group,the airway seal pleasure was higher than the peak inspiratory pressures（PIP） after CO2 pneumoperitoneum. Conclusion It is safe and convenient to use PLMA for ventilation with effective ventilation,stable anesthesia and less complication.

关 键 词：食管引流型喉罩 腹腔镜 气管插管 胆囊切除术 

分 类 号：R614.2[医药卫生—麻醉学]