三通喉罩用于犬支气管肺灌洗术对血流动力学、呼吸功能和应激激素水平的影响  

Effects of three-way laryngeal mask airway on hemodynamics, respiratory function and stress responses to canine undergoing bronchoalveolar lavage

作　　者：韦奇志 杨天明[2] 陆卫忠[3] 范学良[2] 

机构地区：[1]广西壮族自治区食品药品检验所,广西南宁530021 [2]解放军第303医院麻醉科,广西南宁530021 [3]解放军第303医院呼吸科,广西南宁530021

出　　处：《中国现代医学杂志》2014年第4期25-29,共5页China Journal of Modern Medicine

摘　　要：目的探讨三通喉罩(three-way laryngeal mask airway,TLMA)与气管导管(tracheal catheter,TC)通气用于犬支气管肺灌洗术(bronchoalveolar lavage,BAL)对血流动力学、呼吸功能和应激激素水平的影响。方法 16只成年犬随机分为TLMA组(T组,n=8)和TC组(C组,n=8),在全身麻醉下实施BAL术。记录麻醉诱导前(T0)、插入TLMA/TC前(T1)、插入TLMA/TC即刻(T2)、插入TLMA/TC通气3 min(T3)、10 min(T4)、实施BAL 10 min(T5)、20 min(T6)、30 min(T7)、拔除TLMA/TC即刻(T8)和拔除TLMA/TC后3 min(T9)的SpO2、MAP和HR。记录T2、T4、T5、T6、T7和T8的潮气量(VT)、气道峰压(Ppeak)及呼气末二氧化碳分压(PETCO2);测定T0、T2、T3、T5、T7、T8和T9的静脉血浆肾上腺素(AE)、和去甲肾上腺素(NE)水平。结果 C组T2、T3、T8时MAP、HR显著高于T组(P<0.05);C组Ppeak在T5、T6和T7显著高于T组(P<0.05),PETCO2在T6、T7显著高于T组(P<0.05);C组AE、NE在T2、T3和T8均显著高于T组(P<0.05)。结论在犬BAL中,使用TLMA或者TC通气都是安全有效的,TLMA通气优于TC通气,血流动力学更稳定,应激反应更轻微。【Objective】To discuss the effects of three-way laryngeal mask airway（TLMA） and tracheal catheter（TC） on hemodynamics, respiratory function and stress responses to dogs undergoing bronchoalveolar lavage（BAL）. 【Method】16 dogs scheduled for BAL under general anesthesia were divided into TLMA group（group T, n =8） and TC group（group C, n =8）. SpO2, MAP and HR were measured at 5 min after entering the surgery room（T0）, immediately before inserting TLMA or TC（T1）, immediately after inserting TLMA or TC（T2）, at 3 min（T3） and 10 min（T4） after mechanical ventilation, at 10 min（T5）, 20 min（T6） and 30 min（T7） during undergoing BAL, immediately after extubating TLMA or TC（T8） and 3 min after extubating TLMA or TC（T9）. The tidal volume（VT）, peak inspiratory airway pressure（Ppeak） and expiratory CO2pressure（PETCO2） were recorded at T2, T4, T5, T6, T7, T8. The venous blood samples were taken at T0, T2, T3, T5, T7, T8, T9time points for the measurements of epinephrine（AE） and norepinephrine（NE） levels with high performance liquid chromatography.【Results】In group C, MAP and HR were significantly higher than those in group T at T2, T3, T8（P 0.05）. In group C, Ppeak and PETCO2were significantly higher than those in group T at T6, T7（P 0.05）, and the AE and NE were also significantly higher in group C than those in group T at T2, T3and T8（P 0.05）.【Conclusions】Ventilation with TLMA in dogs undergoing BAL is better than TC in keeping stable ventilation, stable hemodynamics and producing less stress responses.

关 键 词：三通喉罩 犬 肺灌洗 全身麻醉 血流动力学 呼吸功能 应激反应 

分 类 号：R-332[医药卫生]