双管喉罩对老年上腹部腹腔镜手术患者围术期呼吸及循环功能的影响  

Effect of double tube laryngeal mask on respiratory and circulatory function in elderly patients undergoing upper abdominal laparoscopic surgery

作　　者：杨玲伟 胡强夫[1] Yang Lingwei;Hu Qiangfu(Department of Anesthesiology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院麻醉科,郑州450052

出　　处：《河南外科学杂志》2024年第5期11-15,共5页Henan Journal of Surgery

摘　　要：目的评价双管喉罩(LAM-Supreme)对老年上腹部腹腔镜手术患者围术期呼吸及循环功能的影响。方法择期全身麻醉下行上腹部腹腔镜手术的老年患者62例,年龄65~75岁,性别不限,ASA分级Ⅱ~Ⅲ级。采用随机数字表法分为喉罩组(L组)33例和气管插管组(E组)29例。比较分析2组患者各时点的血流动力学、呼吸参数指标,以及术后恢复情况。结果2组患者麻醉诱导前(T_(0))时MAP、HR的差异无统计学意义(P>0.05),L组置管(喉罩)即刻(T_(1))时的HR、MAP和拔除气管导管(喉罩)即刻(T_(3))时的MAP低于E组,差异有统计学意义(P<0.05)。2组患者不同时间点的PaO_(2)/FiO_(2)差异无统计学意义(P>0.05),2组T_(2)和T_(3)时的PETCO_(2)均高于T_(1),PaO_(2)/FiO_(2)均低于T_(1),差异均有统计学意义(P<0.05)。E组T_(2)和T_(3)时的PETCO_(2)均低于L组,差异均有统计学意义(P<0.05)。T_(1)时2组患者的P_(peak)、P_(plat)、Cdyn差异无统计学意义(P>0.05),2组患者T_(2)、T_(3)时D的Cdyn均低于T_(1),差异有统计学意义(P<0.05)。T_(2)时E组的P_(peak)、P_(plat)高于L组,Cdyn低于L组,差异有统计学意义(P<0.05)。L组患者T_(2)、T_(3)时的P_(peak)、P_(plat)高于T_(1),E组患者T_(2)时P_(peak)、P_(plat)高于T_(1),差异有统计学意义(P<0.05)。L组患者的术后并发症总发生率低于E组,差异有统计学意义(P<0.05)。结论与气管插管比较,LAM-Supreme更有利于维护全麻老年上腹部腹腔镜手术患者围术期的呼吸及循环功能,减少术后并发症的发生风险。Objective To evaluate the effects of LAM-Supreme on perioperative respiratory and circulatory function in elderly patients undergoing upper abdominal laparoscopic surgery.Methods Sixty-two elderly patients with upper abdominal laparoscopic surgery under elective general anesthesia,aged 65~75 years old,gender unlimited,ASA grade II to III.Random number table method was used to divide 33 cases into laryngeal mask group(group L)and 29 cases into tracheal intubation group(group E).The hemodynamics,respiratory parameters and postoperative recovery of the two groups were compared and analyzed.Results There were no statistically significant differences in MAP and HR between the 2 groups before anesthesia induction(T_(0))(P>0.05),but HR and MAP in group L immediately after catheterization(laryngeal mask)(T_(1))and immediately after tracheal catheter removal(laryngeal mask)(T_(3))were lower than those in group E(P<0.05).There was no statistical significance in PaO_(2)/FiO_(2)between the 2 groups at different time points(P>0.05),P_(ET) CO_(2)at T_(2)and T_(3)was higher than T_(1),and PaO_(2)/FiO_(2)was lower than T_(1)in the 2 groups,with statistical significance(P<0.05).P_(ET) CO_(2)in group E at T_(2)and T_(3)was lower than that in group L,and the differences were statistically significant(P<0.05).There was no significant difference in P_(peak),P_(plat) and Cdyn between the 2 groups at T_(1)(P>0.05),and Cdyn in D at T_(2)and T_(3)was lower than that at T_(1),with statistical significance(P<0.05).At T_(2),P_(peak) and P_(plat) in group E were higher than those in group L,and Cdyn was lower than that in group L,with statistical significance(P<0.05).P_(peak) and P_(plat) at T_(2)and T_(3)in group L were higher than those at T_(1),and P_(peak) and P_(plat) at T_(2)in group E were higher than those at T_(1),with statistical significance(P<0.05).The total incidence of postoperative complications in group L was lower than that in group E,and the difference was statistically significant(P<0.05).Conclusion Compared with tracheal

关 键 词：喉罩 气管插管 围术期 老年腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学]