SLIPA喉罩和气管插管全身麻醉在小儿手术中的应用比较  

Comparison of application of SLIPA laryngeal mask airway and general anesthesia with endotracheal intubation in pediatric operations

作　　者：王茜[1] 李志全[1] 方略[1] 赵泽宇 

机构地区：[1]广元市中心医院麻醉科,四川广元628000 [2]四川省八一康复中心麻醉科,成都611135

出　　处：《检验医学与临床》2015年第7期905-906,909,共3页Laboratory Medicine and Clinic

基　　金：四川省卫生厅科研课题(130250)

摘　　要：目的比较SLIPA喉罩和气管插管全身麻醉对小儿血流动力学的影响及术后拔除气管导管或喉罩时并发症的发生情况。方法将择期行下腹部及下肢手术的患儿50例,分为SLIPA喉罩组(S组)和气管插管组(E组),每组25例。记录麻醉前(T0)、插管/罩前(T1)、插管/罩后(T2)、拔管/罩前(T3),以及拔管/罩后1 min(T4)、5min(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR),记录拔除气管导管或喉罩时发生呛咳、喉痉挛或支气管痉挛、呕吐、声音嘶哑、术后咽痛等并发症的情况。结果与T0比较,两组患儿在T1时SBP、DBP、HR均明显降低(P<0.05);与T1比较,E组SBP、DBP、HR在T2、T4时明显升高(P<0.05);与S组比较,E组SBP、DBP、HR在T2、T4时明显升高(P<0.05)。术后拔除气管导管或喉罩时,S组患儿发生呛咳、术后声音嘶哑、术后咽痛的比例均明显低于E组(P<0.05)。结论 SLIPA喉罩通气用于小儿下腹部及四肢手术时,应激反应小,术后咽部并发症少。Objective To compare the effects of SLIPA laryngeal mask airway and endotracheal intubation anesthesia on hemodynamics in children and the complications after extubation or removal of laryngeal mask airway.Methods 50 children undergoing lower abdominal and lower limb operations were selected and divided into SLIPA laryngeal mask group（group S）and endotracheal intubation group（group E）,with 25 cases in each group.The blood pressure（SBP and DBP）and heart rate（HR）were recorded respectively before anesthesia（T0）,before intubation or inserting laryngeal mask airway（T1）,after intubation or inserting laryngeal mask（T2）,before extubation or removal of laryngeal mask airway（T3）,1min after extubation or removal of laryngeal mask airway（T4）,and 5min after extubation or removal of laryngeal mask airway（T5）.The complications such as cough,laryngeal spasm or bronchial spasm,vomiting,hoarseness,sore throat while extubation or removal of laryngeal mask airway were also recorded.Results Compared with T0,SBP,DBP and HR in two groups were decreased at T1（P〈0.05）.Compared with T1,SBP,DBP and HR in group E were significantly increased at T2 and T4（P〈0.05）,which were also significantly higher than those in group S at T2 and T4（P〈0.05）.After extubation or removal of laryngeal mask airway,the incidences of cough,hoarseness,and sore throat were significantly lower in group S than those in group E（P〈0.05）.Conclusion SLIPA laryngeal mask ventilation can provide less stress reaction and complications of pharynx in pediatric abdomen and limbs operations.

关 键 词：SLIPA喉罩 气管插管 精神运动性激动 全身麻醉 儿童 

分 类 号：R739.41[医药卫生—肿瘤]