当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2013年
27期
33-35
,共3页
范文锋%蒋建平%钟东海%李智睿%莫志仙
範文鋒%蔣建平%鐘東海%李智睿%莫誌仙
범문봉%장건평%종동해%리지예%막지선
喉罩%气管内插管%小儿麻醉
喉罩%氣管內插管%小兒痳醉
후조%기관내삽관%소인마취
Laryngeal mask%Endotracheal intubation%Pediatric anesthesia
目的观察在小儿全身麻醉中喉罩与气管插管对小儿血流动力学和气道压的影响,并探讨其对小儿麻醉的安全性。方法选择3~9岁,美国麻醉医师协会(ASA)Ⅰ或Ⅱ级的择期全身麻醉手术患儿30例,随机分成喉罩组(A组)和气管插管组(B组)各15例。麻醉诱导后插入喉罩或气管导管行机械通气,观察患儿入室时(T 0)、诱导后(T 1)、插入喉罩或气管导管即刻(T 2)、1 min(T 3)、3 min(T 4)、5 min(T 5)、拔出喉罩或气管导管前(T 6)和拔出喉罩或气管导管即刻(T 7)、1 min(T 8)、3 min(T 9)的SBP、DBP、平均动脉压(MAP)、HR、脉搏血氧饱和度(SpO 2)情况,并同时记录T 3~T 6时气道平台压(Pplat)、气道峰压(Ppeak),喉罩或气管导管置入时间、置入难度、咽喉疼痛、呛咳等并发症。结果与T 1时比较,B组T 2时的HR(116.3±15.4)明显增快(P<0.05),SBP (114.5±12.4)、DBP(61.9±13.0)、MAP(83.9±13.6)明显升高(P<0.05);T 2~T 5、T 7~T 9时,B组HR快于A组(P<0.05);两组Ppeak比较,T 3~T 6时A组低于B组(P<0.05);两组并发症呛咳和咽喉疼痛比较,A组(0%、6.7%)的发生率低于B组(26.7%、46.7%)(P<0.05);两组喉罩或气管导管置入固定时间比较A组(12.2±2.2)s长于B组(4.8±1.9)s(P<0.05)。结论喉罩应用于小儿全身麻醉对血流动力学影响小,气道压平稳,术后并发症少,可安全有效地用于小儿全身麻醉气道管理。
目的觀察在小兒全身痳醉中喉罩與氣管插管對小兒血流動力學和氣道壓的影響,併探討其對小兒痳醉的安全性。方法選擇3~9歲,美國痳醉醫師協會(ASA)Ⅰ或Ⅱ級的擇期全身痳醉手術患兒30例,隨機分成喉罩組(A組)和氣管插管組(B組)各15例。痳醉誘導後插入喉罩或氣管導管行機械通氣,觀察患兒入室時(T 0)、誘導後(T 1)、插入喉罩或氣管導管即刻(T 2)、1 min(T 3)、3 min(T 4)、5 min(T 5)、拔齣喉罩或氣管導管前(T 6)和拔齣喉罩或氣管導管即刻(T 7)、1 min(T 8)、3 min(T 9)的SBP、DBP、平均動脈壓(MAP)、HR、脈搏血氧飽和度(SpO 2)情況,併同時記錄T 3~T 6時氣道平檯壓(Pplat)、氣道峰壓(Ppeak),喉罩或氣管導管置入時間、置入難度、嚥喉疼痛、嗆咳等併髮癥。結果與T 1時比較,B組T 2時的HR(116.3±15.4)明顯增快(P<0.05),SBP (114.5±12.4)、DBP(61.9±13.0)、MAP(83.9±13.6)明顯升高(P<0.05);T 2~T 5、T 7~T 9時,B組HR快于A組(P<0.05);兩組Ppeak比較,T 3~T 6時A組低于B組(P<0.05);兩組併髮癥嗆咳和嚥喉疼痛比較,A組(0%、6.7%)的髮生率低于B組(26.7%、46.7%)(P<0.05);兩組喉罩或氣管導管置入固定時間比較A組(12.2±2.2)s長于B組(4.8±1.9)s(P<0.05)。結論喉罩應用于小兒全身痳醉對血流動力學影響小,氣道壓平穩,術後併髮癥少,可安全有效地用于小兒全身痳醉氣道管理。
목적관찰재소인전신마취중후조여기관삽관대소인혈류동역학화기도압적영향,병탐토기대소인마취적안전성。방법선택3~9세,미국마취의사협회(ASA)Ⅰ혹Ⅱ급적택기전신마취수술환인30례,수궤분성후조조(A조)화기관삽관조(B조)각15례。마취유도후삽입후조혹기관도관행궤계통기,관찰환인입실시(T 0)、유도후(T 1)、삽입후조혹기관도관즉각(T 2)、1 min(T 3)、3 min(T 4)、5 min(T 5)、발출후조혹기관도관전(T 6)화발출후조혹기관도관즉각(T 7)、1 min(T 8)、3 min(T 9)적SBP、DBP、평균동맥압(MAP)、HR、맥박혈양포화도(SpO 2)정황,병동시기록T 3~T 6시기도평태압(Pplat)、기도봉압(Ppeak),후조혹기관도관치입시간、치입난도、인후동통、창해등병발증。결과여T 1시비교,B조T 2시적HR(116.3±15.4)명현증쾌(P<0.05),SBP (114.5±12.4)、DBP(61.9±13.0)、MAP(83.9±13.6)명현승고(P<0.05);T 2~T 5、T 7~T 9시,B조HR쾌우A조(P<0.05);량조Ppeak비교,T 3~T 6시A조저우B조(P<0.05);량조병발증창해화인후동통비교,A조(0%、6.7%)적발생솔저우B조(26.7%、46.7%)(P<0.05);량조후조혹기관도관치입고정시간비교A조(12.2±2.2)s장우B조(4.8±1.9)s(P<0.05)。결론후조응용우소인전신마취대혈류동역학영향소,기도압평은,술후병발증소,가안전유효지용우소인전신마취기도관리。
Objective To observe the effect of endotracheal intubation and classic laryngeal mask in pediatric anesthesia on hemodynamic effects and airway pressure,and to investigate safety of laryngeal mask in pediatric anaesthesia.Methods Thirty ASAⅠorⅡchidren,aged 3 to 9 years old,undergoing surgery under general anesthsia,were randomly into two groups;the ET group(group A) and LMA group(group B),with iffteen cases in each group. The ET or LMA was inserted after general anaesthesia.SBP,DBP,MAP, HR, SpO 2 were recorded before and during anesthesia. Pplat and Ppeak were observed as well.The time of ET or LMA ,dififcult,sore throat,bucking were recorded. Results Compared to T 1SBP,DBP,MAP and HR in group B was signiifcantly higher at T 2(P<0.05).The HR of group B was faster than group A at T 2-T 5 and T 7-T 9(P<0.05). The Ppeak of group B were higher than group A at T 3-T 6(P<0.05). The incidence of bucking and sore throat in group A was signiifcantly lower than group B(P<0.05). The time of ET or LMA in group B was short than that in group A . Conclusion LMA can be safely and effectively used in airway management of pediatric anesthesia.