喉罩麻醉与气管内插管麻醉对老年腹腔镜胆囊手术患者呼吸及循环功能的影响  

The elderly laparoscopic operation were carried out with laryngeal mask anesthesia and endotracheal intubation anesthesia effect on the respiration and circulation function

作　　者：雷玲[1] 高元朝[1] 赵志斌[1] 

机构地区：[1]江苏省连云港市第一人民医院麻醉科,江苏连云港222000

出　　处：《临床和实验医学杂志》2015年第17期1482-1485,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探究老年人腹腔镜胆囊手术分别开展喉罩麻醉和气管内插管麻醉对其呼吸及循环功能的影响,并为这类患者临床麻醉方案的最优化选择积累经验。方法选取于2012年4月至2014年5月收治的84例行腹腔镜胆囊摘除术老年患者,利用随机数字表法进行分组,分别设为研究组和对照组,每组各42例。其中对照组开展气管内插管麻醉,研究组则开展喉罩全麻。记录两组患者围手术期各监测时间点的循环、呼吸功能及并发症发生率,并对比分析。结果两组插入前的心率(HR)及平均动脉压(MAP)值差异无统计学意义(P>0.05);研究组在插入后即刻、插入后3min、拔除前即刻、拔除后即刻、拔出后3 min的HR及MAP值均低于对照组,差异有统计学意义(P<0.05)。两组患者在插入前、插入后即刻、拔除后即刻及拔除后3 min的PAW和PETCO2值差异无统计学意义(P>0.05);研究组在插入后3 min及拔除前即刻气道压力(PAW)及呼气末二氧化碳分压(PETCO2)差异无统计学意义(P>0.05)。研究组麻醉期间不良反应发生率低于对照组(16.7%比47.6%),差异有统计学意义(P<0.05)。结论喉罩麻醉应用于老年人腹腔镜胆囊手术,相较于气管内插管,能有效减轻机体在麻醉操作时的应激反应,利于循环及呼吸功能的稳定性,且安全性可,值得进一步推广。Objective To explore the effect on the respiration and circulation function with laryngeal mask anesthesia and endotracheal in-tubation anesthesia in the elderly laparoscopic operation,and to accumulate experience for this kind of patients in clinical anesthesia alternatives. Methods 84 cases of laparoscopic cholecystectomy patients form 2012 April to 2014 May were included into this study. Using random number ta-ble method for grouping,they were divided into study group and control group,each group had 42 cases. The control group were carried out endo-tracheal intubation anesthesia. The study group were carried out the laryngeal mask anesthesia. Patients in two groups were recorded in the circula-tion,respiratory function and complications during the operation of each monitoring point in time the incidence,and make a comparison. Results The two groups before insertion of HR and MAP were not statistically significant( P >0. 05). Study group after insertion,removal of 3min,im-mediately after insertion immediately before,immediately after removal,pull out the HR and MAP values of 3min were lower than those of the con-trol group. The difference was statistically significant( P <0. 05). Two groups of patients in the insert,removal immediately and after removal of 3 min PAW and PETCO2 values had no significant difference( P >0. 05). The study group after insertion and removal of 3 min immediately be-fore PAW and PETCO2 values had no significant difference( P >0. 05). The occurrence rate in the research group of anesthetic adverse reactions was 16. 7%(7/42),the control group the incidence of adverse reaction was 47. 6%(20/42). The difference was statistically significant( P <0. 05). Conclusion Laryngeal mask anesthesia in the elderly laparoscopic operation,compared with endotracheal intubation,can effectively re-duce the stress response to anesthesia operation,be conducive to the stability of circulatory and respiratory function,and security. This method is worthy of further promotion.

关 键 词：老年人 腹腔镜 胆囊手术 喉罩麻醉 气管内插管 呼吸功能 循环功能 

分 类 号：R614[医药卫生—麻醉学]