不同气道管理方式下静脉全身麻醉对输尿管钬激光治疗输尿管结石的影响  

Effect of intravenous general anesthesia under different airway management modes on ureteral holmium laser in the treatment of ureteral calculi

作　　者：贾暄东 廖兴志[1] 周脉涛[1] 刘婷[1] JIA Xuandong;LIAO Xingzhi;ZHOU Maitao;LIU Ting(Department of Anesthesiology,the 904 Hospital of the Joint Logistic Support Force of the People′s Liberation Army,Wuxi,Jiangsu 214000,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院麻醉科,江苏无锡214000

出　　处：《检验医学与临床》2021年第7期913-915,918,共4页Laboratory Medicine and Clinic

基　　金：江苏省无锡市卫计委技术推广项目(T201825)。

摘　　要：目的分析面罩复合鼻咽通气道与喉罩通气模式下实施静脉全身麻醉对输尿管钬激光治疗输尿管结石的影响。方法选取2019年1月至2020年6月到该院进行输尿管结石治疗的患者160例,均行静脉全身麻醉下输尿管镜钬激光碎石术。采用随机、双盲法将其分为面罩复合鼻咽通气道组(S1组)和喉罩组(S2组),每组80例。比较并分析两组患者平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))、手术时间、术后康复时间、不良反应率、结石清除率、治疗优良率及患者满意度等。结果组内比较,两组患者置入喉罩或者鼻咽通气道(面罩)时刻(T1)的MAP、HR均明显低于麻醉诱导前时刻(T0)和拔出时刻(T2),差异有统计学意义(P<0.05),各时刻SpO_(2)差异无统计学意义(P>0.05);组间比较,S1组T1时刻MAP较S2组低,差异有统计学意义(P<0.05),HR、SpO_(2)差异无统计学意义(P>0.05);两组手术时间、不良反应率及患者满意度比较,差异有统计学意义(P<0.05);术后康复时间、结石清除率以及优良率比较,差异无统计学意义(P>0.05)。结论与喉罩相比,面罩复合鼻咽通气道静脉全身麻醉应用于输尿管钬激光治疗输尿管结石,对血流动力学影响较小,能明显减少术后黏膜损伤等并发症,提高患者的满意度,且通气效果明显,实施简单易行。Objective To analyze the effect of intravenous general anesthesia under mask combined nasopharyngeal airway and laryngeal mask ventilation mode on ureteral calculi.Methods From January 2019 to June 2020,160 cases of ureteral calculi treated in our hospital were selected and randomized,double-blind divided into face mask combined with nasopharyngeal airway group(S1 group)and laryngeal mask airway group(S2 group),80 cases in each group.Mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO_(2)),operation time,postoperative recovery time,adverse reaction rate,stone clearance rate,excellent and good rate of treatment and patient satisfaction were compared and analyzed between two groups.Results Intragroup comparison showed that MAP and HR at the time of implantation(T1)were significantly lower than those at the time before induction(T0)and withdrawal(T2),with statistical significance(P<0.05),while SpO_(2)at each time had no statistical significance(P>0.05).The MAP at T1 in S1 group was lower than that in S2 group with statistically significant difference(P<0.05),but HR and SpO_(2)showed no significant difference(P>0.05).There were statistically significant differences in operation time,adverse reaction rate and patient satisfaction between the two groups(P<0.05).There were no statistically significant difference in the postoperative recovery time,stone clearance rate and excellent and good rate(P>0.05).Conclusion Compared with the laryngeal mask airway,face mask combined with nasopharyngeal airway vein general anesthesia for ureteral holmium laser treatment of ureteral calculi has little influence on hemodynamics,can significantly reduce postoperative complications such as mucosal injury,improve patient satisfaction,and has obvious ventilation effect,which is easy to implement.

关 键 词：输尿管镜 钬激光 输尿管结石 喉面罩 气道管理 

分 类 号：R693.4[医药卫生—泌尿科学] R614.2[医药卫生—外科学]