中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
16期
16-18
,共3页
双管喉罩%胸主动脉夹层动脉瘤%介入治疗
雙管喉罩%胸主動脈夾層動脈瘤%介入治療
쌍관후조%흉주동맥협층동맥류%개입치료
Proseal laryngeal mask%Thoracic aortic dissection aneurysm%Interventional therapy
目的 探讨双管喉罩全麻在胸主动脉夹层动脉瘤介入治疗中的临床应用效果.方法 选择择期行覆膜支架介入治疗胸主动脉夹层动脉瘤患者40例,ASAⅡ～Ⅲ级.将其随机分为气管插管全麻组(ET组)和双管型喉罩全麻组(PLMA组),每组各20例.观察两组各时点血流动力学、脉搏血氧饱和度(SpO2)、术毕清醒拔管时间、术中麻醉药及降压药用量、麻醉相关并发症.结果 患者的收缩压(SBP)、平均动脉压(MAP)和心率(HR),在插管前(T2)ET组显著低于PLMA组(P＜0.05),在气管插管即刻(T3)、拔管即刻(T5)两个时点ET组显著高于PLMA组(P＜0.05).PLMA组患者麻醉诱导及术中维持所需麻醉药量均较ET组少(P＜0.05),PLMA组硝普钠用量显著少于ET组(P＜0.05),PLMA组患者术后清醒恢复快(P＜0.05),两组患者术中及术后未发生麻醉相关并发症.结论 双管型喉罩全麻用于覆膜支架介入治疗胸主动脉夹层动脉瘤效果良好,麻醉的可控性大大增加,麻醉风险降低,较传统气管插管麻醉方式有很大的优势,是一种值得临床推广应用的方法.
目的 探討雙管喉罩全痳在胸主動脈夾層動脈瘤介入治療中的臨床應用效果.方法 選擇擇期行覆膜支架介入治療胸主動脈夾層動脈瘤患者40例,ASAⅡ～Ⅲ級.將其隨機分為氣管插管全痳組(ET組)和雙管型喉罩全痳組(PLMA組),每組各20例.觀察兩組各時點血流動力學、脈搏血氧飽和度(SpO2)、術畢清醒拔管時間、術中痳醉藥及降壓藥用量、痳醉相關併髮癥.結果 患者的收縮壓(SBP)、平均動脈壓(MAP)和心率(HR),在插管前(T2)ET組顯著低于PLMA組(P＜0.05),在氣管插管即刻(T3)、拔管即刻(T5)兩箇時點ET組顯著高于PLMA組(P＜0.05).PLMA組患者痳醉誘導及術中維持所需痳醉藥量均較ET組少(P＜0.05),PLMA組硝普鈉用量顯著少于ET組(P＜0.05),PLMA組患者術後清醒恢複快(P＜0.05),兩組患者術中及術後未髮生痳醉相關併髮癥.結論 雙管型喉罩全痳用于覆膜支架介入治療胸主動脈夾層動脈瘤效果良好,痳醉的可控性大大增加,痳醉風險降低,較傳統氣管插管痳醉方式有很大的優勢,是一種值得臨床推廣應用的方法.
목적 탐토쌍관후조전마재흉주동맥협층동맥류개입치료중적림상응용효과.방법 선택택기행복막지가개입치료흉주동맥협층동맥류환자40례,ASAⅡ～Ⅲ급.장기수궤분위기관삽관전마조(ET조)화쌍관형후조전마조(PLMA조),매조각20례.관찰량조각시점혈류동역학、맥박혈양포화도(SpO2)、술필청성발관시간、술중마취약급강압약용량、마취상관병발증.결과 환자적수축압(SBP)、평균동맥압(MAP)화심솔(HR),재삽관전(T2)ET조현저저우PLMA조(P＜0.05),재기관삽관즉각(T3)、발관즉각(T5)량개시점ET조현저고우PLMA조(P＜0.05).PLMA조환자마취유도급술중유지소수마취약량균교ET조소(P＜0.05),PLMA조초보납용량현저소우ET조(P＜0.05),PLMA조환자술후청성회복쾌(P＜0.05),량조환자술중급술후미발생마취상관병발증.결론 쌍관형후조전마용우복막지가개입치료흉주동맥협층동맥류효과량호,마취적가공성대대증가,마취풍험강저,교전통기관삽관마취방식유흔대적우세,시일충치득림상추엄응용적방법.
Objective To investigate the clinical application effect of proseal laryngeal mask on anesthesia of interventional therapy for thoracic aortic dissecting aneurysm.Methods Forty patients with thoracic aortic dissection aneurysm underwent endovascular stent graft repair,ASA Ⅱ ～ Ⅲ,were randomly divided into endotracheal intubation anesthesia group (group ET) and proseal laryngeal mask anesthesia group(group PLMA),with 20 cases in each group.During operation,the hemodynamics,pulse oxygen saturation (SpO2),drug dosage,recovery and extubation time,anesthesia related complications of patients were observed.Results At before intubation (T2),the SBP,MAP and HR of patients in group ET were significantly lower than those in group PLMA (P ＜ 0.05).At endotracheal intubation immediate (T3) and extubation immediate (T5) time,the SBP,MAP and HR of patients in group ET were significantly higher than those in group PLMA (P ＜ 0.05).Anesthetics dosage of anesthesia induction and anesthetics dosage of maintenance of anesthesia in group PLMA were fewer than those in group ET (P ＜0.05).Sodium nitroprusside dosage of patients in group PLMA were significantly less than that in group ET(P ＜ 0.05).The patients in group PLMA awaked more rapidly (P ＜ 0.05).During intraoperative and postoperative periods,complications associated with anesthesia had not occurre in the two groups.Conclusions The effect of proseal laryngeal mask anesthesia on endovascular stent graft repair of thoracic aortic dissecting aneurysm is good,the anesthetic controllability increases greatly,the anesthetic risk is lowered.Compared with traditional endotracheal intubation anesthesia,proseal laryngeal mask anesthesia has a lot of advantages,is worthy to be popularized in clinics.
