中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
17期
22-24
,共3页
Supreme喉罩%血液动力学%通气功能%腹腔镜手术
Supreme喉罩%血液動力學%通氣功能%腹腔鏡手術
Supreme후조%혈액동역학%통기공능%복강경수술
Supreme laryngeal mask airway%Heamodynamics%Respiratory function%Laparoscopic cholecystectomy
目的 比较双腔Supreme喉罩和气管插管对妇科腹腔镜手术患者血流动力学和通气功能的影响.方法 择期行妇科腹腔镜手术者80例,ASA Ⅰ～Ⅱ级.随机分为两组,即喉罩组(LMA组,40例)和气管插管组(ET组,40例).比较两组患者麻醉诱导前(T0)、诱导后(T1)、插入喉罩/气管导管后即刻(T2)及插入喉罩/气管寻管后3 min(T3)、拔管前(T4)、拔管即刻(T5)、拔管后3 min(T6)患者的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)；记录间歇正压通气5 min(T7)、15 min(T8)、30 min(T9)的分钟通气量(MV)、气道峰压(Ppeak)、潮气量(VT)和呼气末二氧化碳分压(PETCO2)；同时记录低氧血症、呛咳、恶心呕吐、声音嘶哑、咽喉痛、反流误吸等不良反应.结果 LMA组、ET组T1时MAP显著低于T0时(p＜0.05)；组间比较T2、T3、T5、T6时点ET组的MAP和HR显著高于LMA组(P＜0.05)；其他时点两组MAP、HR比较差异无统计学意义；SpO2均维持在95％～100％.两组T7～T8时点MV、VT、PETCO2、Ppeak比较差异无统计学意义,T9时点PETCO2、Ppeak喉罩组高于气管插管组；Supreme喉罩组的不良反应低于气管插管组.结论 Supreme喉罩可安全用于妇科腹腔镜手术患者,通气可靠,对血流动力学影响轻微,并且不良反应发生率低.
目的 比較雙腔Supreme喉罩和氣管插管對婦科腹腔鏡手術患者血流動力學和通氣功能的影響.方法 擇期行婦科腹腔鏡手術者80例,ASA Ⅰ～Ⅱ級.隨機分為兩組,即喉罩組(LMA組,40例)和氣管插管組(ET組,40例).比較兩組患者痳醉誘導前(T0)、誘導後(T1)、插入喉罩/氣管導管後即刻(T2)及插入喉罩/氣管尋管後3 min(T3)、拔管前(T4)、拔管即刻(T5)、拔管後3 min(T6)患者的平均動脈壓(MAP)、心率(HR)、脈搏血氧飽和度(SpO2)；記錄間歇正壓通氣5 min(T7)、15 min(T8)、30 min(T9)的分鐘通氣量(MV)、氣道峰壓(Ppeak)、潮氣量(VT)和呼氣末二氧化碳分壓(PETCO2)；同時記錄低氧血癥、嗆咳、噁心嘔吐、聲音嘶啞、嚥喉痛、反流誤吸等不良反應.結果 LMA組、ET組T1時MAP顯著低于T0時(p＜0.05)；組間比較T2、T3、T5、T6時點ET組的MAP和HR顯著高于LMA組(P＜0.05)；其他時點兩組MAP、HR比較差異無統計學意義；SpO2均維持在95％～100％.兩組T7～T8時點MV、VT、PETCO2、Ppeak比較差異無統計學意義,T9時點PETCO2、Ppeak喉罩組高于氣管插管組；Supreme喉罩組的不良反應低于氣管插管組.結論 Supreme喉罩可安全用于婦科腹腔鏡手術患者,通氣可靠,對血流動力學影響輕微,併且不良反應髮生率低.
목적 비교쌍강Supreme후조화기관삽관대부과복강경수술환자혈류동역학화통기공능적영향.방법 택기행부과복강경수술자80례,ASA Ⅰ～Ⅱ급.수궤분위량조,즉후조조(LMA조,40례)화기관삽관조(ET조,40례).비교량조환자마취유도전(T0)、유도후(T1)、삽입후조/기관도관후즉각(T2)급삽입후조/기관심관후3 min(T3)、발관전(T4)、발관즉각(T5)、발관후3 min(T6)환자적평균동맥압(MAP)、심솔(HR)、맥박혈양포화도(SpO2)；기록간헐정압통기5 min(T7)、15 min(T8)、30 min(T9)적분종통기량(MV)、기도봉압(Ppeak)、조기량(VT)화호기말이양화탄분압(PETCO2)；동시기록저양혈증、창해、악심구토、성음시아、인후통、반류오흡등불량반응.결과 LMA조、ET조T1시MAP현저저우T0시(p＜0.05)；조간비교T2、T3、T5、T6시점ET조적MAP화HR현저고우LMA조(P＜0.05)；기타시점량조MAP、HR비교차이무통계학의의；SpO2균유지재95％～100％.량조T7～T8시점MV、VT、PETCO2、Ppeak비교차이무통계학의의,T9시점PETCO2、Ppeak후조조고우기관삽관조；Supreme후조조적불량반응저우기관삽관조.결론 Supreme후조가안전용우부과복강경수술환자,통기가고,대혈류동역학영향경미,병차불량반응발생솔저.
Objective To compare the effects of supreme laryngeal mask airway(LMA) and endotracheal intubation(ET) on hemodynamics and respiratory function in patients underwent laparoscopic cholecystectomy.Methods Eighty patients(ASA class Ⅰ or Ⅱ),scheduled for laparoscopic cholecystectomy under general anesthesia were randomly divided into LMA group (n =40) and ET group (n =40)with mechanical ventilation.MAP,HR and SpO2 were recorded before anesthesia induction(T0),before intubation (T1),after intubation immediately (T2),3 min after intubation(T3),before extubation(T4),after extubation immediately(T5),3 min after extubation(T6).The tidal volume(VT),minute ventialtion(MV),peak inspiratory pressure(Ppeak) and PETCO2 were recorded at 5 min(T7),15 min(T8),30 min(T9) of deflation.And the adverse reactions such as hypoxemia,cough,nausea and vomiting,hoarseness,sore throat,regurgitation and aspiration were recorded.Results MAP in LMA and ET group at T1 was significantly lower than those at T0.In group ET,HR and MAP were significantly higher than those in group LMA at T2,T3,T5,T6 (P ＜ 0.05).There was no significant difference in VT,MV,Ppeak or PETCO2 between the two groups at T7,T8(P ＞0.05).Ppeak and PETCO2 in group LMA were significantly higher than those in group ET.The icidences of adverse reactions were lower.Conclusions Ventilation with LMA in patients underwent laparoscopic cholecystectomy is effective for mechanical ventilation,with simpler operation and mild cardiovascular adverse response.
