欧普乐喉罩在妇科恶性肿瘤切除术麻醉中的应用  

Value of oro-pharyngeal airway cap in anesthesia during resection of gynecological malignancies

作　　者：廖常莉 姜鲜 赵晓蓉 刘清湄 周军 LIAO Changli;JIANG Xian;ZHAO Xiaorong;LIU Qingmei;ZHOU Jun(Department of Anesthesiology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院麻醉科,四川泸州646000

出　　处：《西南医科大学学报》2018年第4期356-360,共5页Journal of Southwest Medical University

基　　金：国家自然科学基金(81301055)

摘　　要：目的:评价欧普乐喉罩(oro-pharyngeal airway cap,OPLAC)通气在妇科恶性肿瘤切除术麻醉中临床应用的安全性和可行性。方法:选择66例择期行全麻下妇科恶性肿瘤切除术的患者,按照随机数字表法分为欧普乐喉罩组(O组)和气管内插管组(T组),每组各33例。观察两组患者在麻醉诱导前(T0),置入喉罩或气管导管即刻(T1),置入喉罩或气管导管后3min(T2),拔除喉罩或气管导管后即刻(T3),拔除喉罩或气管导管后3 min(T4),5个时间点的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2),同时在10 m L/kg潮气量下监测T1~T3的平均气道压(Pmean),气道峰压(Ppeak)和呼气末二氧化碳分压(Pet CO2),并记录有无咳嗽、咽痛等相关并发症。结果:T组T1、T3、T4时点的MAP和HR均明显高于O组同时点,差异均有统计学意义(P<0.05);T组在T1~T3时点的Pmean和Ppeak明显高于O组同时点(P<0.05);O组呛咳、苏醒期躁动、术后咽痛、痰多等术后并发症总发生率明显少于T组(P<0.05)。结论:欧普乐喉罩通气应用于妇科恶性肿瘤切除术,围术期血流动力学更加稳定,应激反应更小,术后咽痛等相关并发症更少。Objective： To investigate the safety and feasibility of oro-pharyngeal airway cap（OPLAC） ventilation in anesthesia during resection of gynecological malignancies. Methods： A total of 66 patients who underwentelective resection of gynecological malignancies under general anesthesia were enrolled and random Ly divided intoOPLAC group（O group） and endotracheal intubation group（T group）, with 33 patients in each group. The two groupswere observed in terms of mean arterial pressure（MAP）, heart rate（HR）, and pulse oximeter saturation（Sp O2） beforeanesthesia induction（T0）, immediately after the placement of OPLAC or endotracheal tube（T1）, at 3 minutes afterthe placement of OPLAC or endotracheal tube（T2）, immediately after the extraction of OPLAC or endotracheal tube（T3）, and at 3 minutes after the extraction of OPLAC or endotracheal tube（T4）;mean airway pressure（Pmean）, peakairway pressure（Ppeak）, and end-tidal partial pressure of carbon dioxide（Pet CO2） at T1, T2, and T3 were monitoredat a tidal volume of 10 m L/kg;complications such as cough and pharyngalgia were recorded. Results： At T1, T3,and T4, the T group had significantly higher MAP and HR than the O group（P〈0.05）. At T1, T2, and T3, the Tgroup had significantly higher Pmean and Ppeak than the O group（P〈0.05）. Compared with the T group, the O group had significantly lower incidence rates of bucking, emergence agitation, postoperative pharyngalgia, and exces-sive phlegm（P〈0.05）. Conclusion： In the resection of gynecological malignancies, OPLAC ventilation can main-tain stable hemodynamic parameters and reduce stress response and postoperative complications including pharyngalgia.

关 键 词：欧普乐喉罩 妇科 恶性肿瘤 全麻 

分 类 号：R614.2[医药卫生—麻醉学]