喉罩通气在腹腔镜胆囊切除术中的应用  

Application of laryngeal mask airway in laparoscopic cholecystectomy

作　　者：石珍珍[1] 肖亚芬 胡蓉[1] 

机构地区：[1]湖南省桃源县人民医院麻醉科,湖南桃源415700

出　　处：《中国现代医生》2013年第24期89-91,共3页China Modern Doctor

摘　　要：目的探讨喉罩麻醉用于腹腔镜胆囊切除术的安全性和可行性。方法选择本院全麻下择期行腹腔镜下胆囊切除术的患者60例,随机分为喉罩组和气管插管组各30例,两组麻醉诱导后分别行喉罩通气和气管插管通气。结果①T2、T3、T6、T7时气管插管组HR、MAP明显高于喉罩组,差异有统计学意义(P<0.05);VT两组内以及T6时组间差异均有统计学意义(P<0.05)。②喉罩组术后躁动、咽喉疼痛、呛咳不良反应发生率明显低于气管插管组,差异有统计学意义(P<0.05)。③二氧化碳气腹后20 min和术后1 h喉罩组患者血C反应蛋白水平明显低于气管插管组,两组差异有统计学意义(P<0.05)。结论喉罩通气在腹腔镜胆囊切除术中可有效减少患者心血管应激反应,通气效果良好,且不良反应少,安全性较高,可替代气管插管通气用于腹腔镜胆囊手术。Objective To investigate the safety and feasibility of laryngeal mask anesthesia for laparoscopic cholecys- tectomy. Methods Sixty patients treated with laparoscopic eholecystectomy under general anesthesia in our hospital were randomly divided into laryngeal mask （LMA） group and tracheal intubation （TI） group, 30 patients in each group. After anesthesia induction, two groups were given laryngeal mask airway and endotracheal intubation ventilation. Re- sults ① In T2,T3,T6,T7 point, HR, MAP of TI group was significantly higher than LMA group, the difference was sta- tistically significant （P 〈 0.05）, in T6 point, VT between two groups were all significantly different （P 〈 0.05）. ② Rest- lessness, sore throat, cough incidence of LMA group was significantly lower than the TI group, the difference was sta tistically significant （P 〈 0.05）. ③ Twenty min after carbon dioxide pneumoperitoneum and 1 h after surgery, the serum C-reactive protein levels of LMA group were significantly lower than TI group, the difference was statistically signifi- cant（P 〈 0.05）. Conclusion The laryngeal mask airway in laparoscopic cholecysteetomy is effective in reducing car diovascular stress response, with good ventilation, less adverse reactions, high security, and can replace endotracheal intubation ventilation for laparoseopic gallbladder surgery.

关 键 词：喉罩通气 腹腔镜胆囊切除术 气管插管 心血管应激反应 

分 类 号：R614.2[医药卫生—麻醉学]