插管型喉罩预防高血压脑出血患者全麻恢复期拔管反应的效果观察  

Observation on effect of intubating laryngeal mask on preventing extubation reaction in patients with hypertensive cerebral hemorrhage during convalescence of general anesthesia

作　　者：刘社景 李新锋[1] 赵二贤[1] 王锋 LIU She-jing;LI Xin-feng;ZHAO Er-xian;WANG Feng(Department of Anesthesiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Zhumadian the First People's Hospital,Zhumadian,Henan 463000,China)

机构地区：[1]郑州大学第一附属医院麻醉科,郑州450052 [2]驻马店市第一人民医院,河南驻马店463000

出　　处：《医药论坛杂志》2024年第2期170-173,共4页Journal of Medical Forum

摘　　要：目的探讨高血压脑出血全麻手术患者应用插管型喉罩(ILMA)对于预防全麻恢复期拔管反应的作用。方法选取郑州大学第一附属医院2019年6月—2021年6月收治的高血压脑出血患者98例,随机分为两组各49例,两组均采用相同的麻醉方案,分别采用气管内插管(对照组)与ILMA(观察组)连接麻醉机呼吸回路,比较两组不同时间点平均动脉压(MAP)与心率、拔管反应以及呛咳的发生率。结果观察组T3、T4、T5、T6各时间点MAP与心率均低于对照组(P<0.05);不同时间点MAP与心率比较,观察组无明显变化(P>0.05),对照组从T3开始各时间点MAP与心率明显升高(P<0.05);观察组拔管反应发生率(4.08%)与呛咳发生率(0.00%)低于对照组(91.84%,93.88%)(P<0.05)。结论血压脑出血全麻手术患者应用ILMA有助于在麻醉恢复期防止拔管反应与呛咳,从而降低发生脑血管意外的风险。Objective To investigate the effect of intubated laryngeal mask(ILMA)on the prevention of extubation re⁃action in patients undergoing general anesthesia for hypertensive cerebral hemorrhage.Methods A total of 98 patients with hypertensive cerebral hemorrhage admitted to the First Affiliated Hospital of Zhengzhou University from June 2019 to June 2021 were randomly divided into observation group and control group,with 49 cases in each group.Both groups were treated with the same anesthesia protocol,and endotracheal intubation(control group)and ILMA(observation group)were respectively used to connect the anesthesia machine breathing circuit.The mean arterial pressure(MAP),heart rate,extubation response and incidence of cough were compared between the two groups at different time points.Results MAP and heart rate at T3,T4,T5 and T6 in the observation group were lower than those in the control group(P<0.05).There was no significant change in MAP and heart rate at different time points in the observation group(P>0.05),while MAP and heart rate in the control group were significantly increased at each time point from T3(P<0.05).The incidences of extubation reaction(4.08%)and choking(0.00%)in the observation group were low⁃er than those in the control group(91.84%,93.88%)(P<0.05).Conclusion The application of ILMA in patients with hypertensive intracerebral hemorrhage under general anesthesia is helpful to prevent extubation reaction and cough during the recovery period of anesthesia,so as to reduce the risk of cerebrovascular accident.

关 键 词：高血压 脑出血 呛咳 麻醉 拔管反应 

分 类 号：R614[医药卫生—麻醉学]