中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2015年
7期
80-80,82
,共2页
乳腺癌改良根治术%喉罩%气管插管%血流动力学%应激反应
乳腺癌改良根治術%喉罩%氣管插管%血流動力學%應激反應
유선암개량근치술%후조%기관삽관%혈류동역학%응격반응
Modified radical mastectomy for breast cancer%Laryngeal mask%Tracheal intubation%Hemodynamics%Stress reaction
目的：探讨在乳腺癌改良根治术中应用喉罩全麻的临床效果。方法：2013年5月-2014年5月收治全麻下乳腺癌改良根治术患者52例，按麻醉方式不同随机分为气管插管全麻组和喉罩全麻组各26例。两组患者依次静注咪达唑仑、芬太尼、异丙酚以及维库溴铵进行麻醉诱导，下颌松弛后进行气管插管或者喉罩置入，观察记录两组患者在麻醉诱导前(T0)和气管插入或喉罩置入时(T1)的血压、心率以及应激激素肾上腺素(E)和去甲肾上腺素(NE)的变化情况。结果：喉罩全麻组在喉罩置入时的收缩压、舒张压、心率以及E和去NE水平与诱导前相比，差异无统计学意义(P＞0.05)；气管插管组在气管插入时的收缩压、舒张压、心率以及E和去NE水平与诱导前和喉罩全麻组相比，差异均有统计学意义(P＜0.05)。结论：对接受乳腺癌改良根治术的患者采用喉罩全麻，有助于维持患者诱导期血流动力学稳定，减轻诱导期应激反应，效果优于气管插管全麻。
目的：探討在乳腺癌改良根治術中應用喉罩全痳的臨床效果。方法：2013年5月-2014年5月收治全痳下乳腺癌改良根治術患者52例，按痳醉方式不同隨機分為氣管插管全痳組和喉罩全痳組各26例。兩組患者依次靜註咪達唑崙、芬太尼、異丙酚以及維庫溴銨進行痳醉誘導，下頜鬆弛後進行氣管插管或者喉罩置入，觀察記錄兩組患者在痳醉誘導前(T0)和氣管插入或喉罩置入時(T1)的血壓、心率以及應激激素腎上腺素(E)和去甲腎上腺素(NE)的變化情況。結果：喉罩全痳組在喉罩置入時的收縮壓、舒張壓、心率以及E和去NE水平與誘導前相比，差異無統計學意義(P＞0.05)；氣管插管組在氣管插入時的收縮壓、舒張壓、心率以及E和去NE水平與誘導前和喉罩全痳組相比，差異均有統計學意義(P＜0.05)。結論：對接受乳腺癌改良根治術的患者採用喉罩全痳，有助于維持患者誘導期血流動力學穩定，減輕誘導期應激反應，效果優于氣管插管全痳。
목적：탐토재유선암개량근치술중응용후조전마적림상효과。방법：2013년5월-2014년5월수치전마하유선암개량근치술환자52례，안마취방식불동수궤분위기관삽관전마조화후조전마조각26례。량조환자의차정주미체서륜、분태니、이병분이급유고추안진행마취유도，하합송이후진행기관삽관혹자후조치입，관찰기록량조환자재마취유도전(T0)화기관삽입혹후조치입시(T1)적혈압、심솔이급응격격소신상선소(E)화거갑신상선소(NE)적변화정황。결과：후조전마조재후조치입시적수축압、서장압、심솔이급E화거NE수평여유도전상비，차이무통계학의의(P＞0.05)；기관삽관조재기관삽입시적수축압、서장압、심솔이급E화거NE수평여유도전화후조전마조상비，차이균유통계학의의(P＜0.05)。결론：대접수유선암개량근치술적환자채용후조전마，유조우유지환자유도기혈류동역학은정，감경유도기응격반응，효과우우기관삽관전마。
Objective:To investigate the clinical effect of the application of laryngeal mask general anesthesia in modified radical mastectomy for breast cancer surgery.Methods:52 patients who had modified radical mastectomy under general anesthesia were selected from May 2013 to May 2014.They were randomly divided into tracheal intubation general anesthesia group and general anesthesia of laryngeal mask group with 26 cases in each group according to the different ways of anesthesia.The two groups patients followed by intravenous injection of midazolam,propofol,fentanyl and vecuronium for induction of anesthesia.We did endotracheal intubation or laryngeal mask airway after mandibular relaxation.We observed the blood pressure,heart rate and stress hormone epinephrine(E) and norepinephrine(NE) changes before the induction of anesthesia(T0) and tracheal insertion or laryngeal mask airway(T1) of the two groups patients.Results:The systolic blood pressure,diastolic blood pressure,heart rate and E and NE levels of the laryngeal mask airway anesthesia group when the laryngeal mask in compared with before the induction,and there were no significant difference(P>0.05);the systolic blood pressure,diastolic blood pressure,heart rate and E and NE levels of the endotracheal intubation group when the laryngeal mask in compared with before the induction and the laryngeal mask airway anesthesia group,and the difference had statistically significant(P<0.05).Conclusion:We give the modified radical mastectomy for breast cancer patients with laryngeal mask airway anesthesia,and it can help to maintain the stability of hemodynamics in patients with induction period,and reduce the induction period of stress reaction.The effect is better than general anesthesia with endotracheal intubation.
