喉罩对比气管插管对先天性儿童白内障手术的影响研究  

Study on effect of laryngeal mask airway versus tracheal intubation on congenital pediatric cataract surgery

作　　者：陈超巧 金约西 程丹 林晓蕾 聂莉 CHEN Chaoqiao;JIN Yuexi;CHENG Dan;LIN Xiaolei;NIE Li(Department of Anesthesiology,the Eye Hospital Affliated to Wenzhou Medical University,Wenzhou 325000,China;Specialty of Ocular Fundus Diseases,the Eye Hospital,Wenzhou Medical niversity,Wenzhou 325000,China;Specialty of Glaucoma,the Eye Hospital Affliated to Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属眼视光医院麻醉科,浙江温州325000 [2]温州医科大学附属眼视光医院眼底病专科,浙江温州325000 [3]温州医科大学附属眼视光医院青光眼专科,浙江温州325000

出　　处：《中国现代医生》2019年第33期92-96,共5页China Modern Doctor

基　　金：浙江省基础公益研究计划项目(LSY19H120001)

摘　　要：目的探讨喉罩和气管插管不同气道管理麻醉方案在先天性白内障儿童手术的影响研究。方法选择2016年6月~2018年6月在我院进行儿童白内障手术的158例患儿作为研究对象。随机将患者分为喉罩组和气管插管组,其中喉罩组79例,气管插管组79例,所有患儿手术前均完善血液及影像学检查,麻醉诱导后,喉罩组采用喉罩麻醉,气管插管组采用气管插管麻醉。比较两组患儿总麻醉效果、导管置入时间、拔管时间;诱导前(T0)、插入喉罩或气管插管后即刻(T1)、插入喉罩或气管插管后3 min(T2)、拔管后即刻(T3)、拔管后3 min(T4)时收缩压、舒张压、心率及眼压变化,同时观察手术过程中麻醉并发症发生情况。结果两组患儿性别、年龄、体重等一般资料无明显差异(P>0.05);喉罩组患儿麻醉总有效率明显高于气管插管组(P<0.05);喉罩组患儿导管置入与拔管时间均明显短于气管插管组(P<0.05);T1、T2、T3及T4时,气管插管组患儿平均动脉压、平均心率及眼压较T0时均明显升高(P<0.05);T1、T2、T3及T4时,气管插管组患儿平均动脉压、平均心率及眼压均明显高于同时段喉罩组(P<0.05);喉罩组患儿术中维持麻醉药物用量均明显低于气管插管组(P<0.05);喉罩组患儿麻醉并发症总发生率明显低于气管插管组,差异有统计学意义(P<0.05)。结论儿童白内障手术对眼压维持要求较高,喉罩麻醉对患儿平均动脉压、平均心率及眼压的影响较小,且置入时间较气管插管短,可有效缩短麻醉时长,并能明显降低麻醉并发症的发生,值得临床推广应用。Objective To study the effect of two different airway management anesthesia schemes(laryngeal mask and endotracheal intubation)on the congenital pediatric cataract surgery.Methods A total of 158 children who underwent cataract surgery in our hospital from June 2016 to June 2018 were selected as subjects.The subjects were randomly divided into the laryngeal mask group and the tracheal intubation group,with 79 subjects in each group.Blood and imaging tests were completed in all patients before surgery.After anesthesia induction,the laryngeal mask group was anesthetized by laryngeal mask airway and the tracheal intubation group was anesthetized by tracheal intubation.The general anesthetic effect,catheter placement time and extubation time of the two groups were compared.The systolic blood pressure,diastolic blood pressure,heart rate and intraocular pressure change of the two groups were observed before induction(T0),immediately after the placement of laryngeal mask or insertion of tracheal intubation(T1),3 minutes after the placement of laryngeal mask or insertion of tracheal intubation(T2),immediately after extubation(T3),and 3 minutes after extubation(T4)and compared.The complications of anesthesia during the surgery were also observed.Results There were no significant differences in gender,age,weight and other general information between the two groups(P>0.05).The total anesthetic effective rate of the laryngeal mask group was significantly higher than that of the tracheal intubation group(P<0.05).The catheter placement time and the extubation time of the laryngeal mask group were both significantly shorter than those of the tracheal intubation group(P<0.05).At T1,T2,T3 and T4,the average arterial pressure,heart rate and intraocular pressure in the tracheal intubation group were significantly higher than those at T0(P<0.05).At T1,T2,T3 and T4,the average arterial pressure,heart rate and intraocular pressure in the tracheal intubation group were significantly higher than those in the laryngeal mask group at the s

关 键 词：儿童白内障手术 喉罩麻醉 气管插管麻醉 

分 类 号：R726.1[医药卫生—儿科]