国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2015年
2期
204-207
,共4页
容英旋%孙春红%李经纬%唐志航%温涛
容英鏇%孫春紅%李經緯%唐誌航%溫濤
용영선%손춘홍%리경위%당지항%온도
喉罩%气管插管%钻孔引流术%全身麻醉
喉罩%氣管插管%鑽孔引流術%全身痳醉
후조%기관삽관%찬공인류술%전신마취
Laryngeal mask airway%Tracheal intubation%Burr hole drainage surgery%General anesthesia
目的 评价喉罩在双侧颅骨钻孔引流手术麻醉中的应用效果.方法 选取64例拟行双侧颅骨钻孔引流手术的患者,按照电脑随机分组的原则分为研究组和对照组各32例.两组的麻醉方法均为全身麻醉,研究组使用喉罩的方式通气,对照组使用气管插管(经口明视)的方式通气.记录两组患者T0(术前)、T1(诱导后3 min)、T2(插气管导管(喉罩)即时)、T3(手术开始时)、T4(术毕)、T5(拔除气管导管(喉罩)时)的血压、心率[MAP、HR]变化及PetCO2(呼末二氧化碳分压)、SpO2(血氧饱和度)的改变,记录手术耗时、拔除气管导管(或喉罩)时、血管活性药物(如阿托品、麻黄素)的应用情况及术中是否出现呛咳、术后有无咽部疼痛等情况.结果 研究组丙泊酚、瑞芬太尼及维库溴铵用量均明显少于对照组[(142±26)mg vs.(180±30)mg,(231±49)μg vs.(292±48)μg,(5±1)mg vs.(8±2)mg],拔管时间明显短于对照组[(3.6±0.7)min vs.(9.2±1.1)min],气管导管或者喉罩的插入、拔除时研究组MAP和HR均低于对照组,差异均有统计学意义(P＜0.05).研究组拔除喉罩时呛咳、咽喉部疼痛、管道带血等情况明显减少(3 vs.28;2 vs.13;1 vs.12),术中患者体动和呛咳等情况明显少于对照组(1 vs.10;0 vs.13),差异均有统计学意义(P＜0.05).结论 双侧颅骨钻孔外引流手术放置喉罩通气是一种可行的、有效的全身麻醉通气方式之一,其操作简易、所需麻醉药物较少、并发症少,可适用于双侧颅骨钻孔外引流手术的麻醉.
目的 評價喉罩在雙側顱骨鑽孔引流手術痳醉中的應用效果.方法 選取64例擬行雙側顱骨鑽孔引流手術的患者,按照電腦隨機分組的原則分為研究組和對照組各32例.兩組的痳醉方法均為全身痳醉,研究組使用喉罩的方式通氣,對照組使用氣管插管(經口明視)的方式通氣.記錄兩組患者T0(術前)、T1(誘導後3 min)、T2(插氣管導管(喉罩)即時)、T3(手術開始時)、T4(術畢)、T5(拔除氣管導管(喉罩)時)的血壓、心率[MAP、HR]變化及PetCO2(呼末二氧化碳分壓)、SpO2(血氧飽和度)的改變,記錄手術耗時、拔除氣管導管(或喉罩)時、血管活性藥物(如阿託品、痳黃素)的應用情況及術中是否齣現嗆咳、術後有無嚥部疼痛等情況.結果 研究組丙泊酚、瑞芬太尼及維庫溴銨用量均明顯少于對照組[(142±26)mg vs.(180±30)mg,(231±49)μg vs.(292±48)μg,(5±1)mg vs.(8±2)mg],拔管時間明顯短于對照組[(3.6±0.7)min vs.(9.2±1.1)min],氣管導管或者喉罩的插入、拔除時研究組MAP和HR均低于對照組,差異均有統計學意義(P＜0.05).研究組拔除喉罩時嗆咳、嚥喉部疼痛、管道帶血等情況明顯減少(3 vs.28;2 vs.13;1 vs.12),術中患者體動和嗆咳等情況明顯少于對照組(1 vs.10;0 vs.13),差異均有統計學意義(P＜0.05).結論 雙側顱骨鑽孔外引流手術放置喉罩通氣是一種可行的、有效的全身痳醉通氣方式之一,其操作簡易、所需痳醉藥物較少、併髮癥少,可適用于雙側顱骨鑽孔外引流手術的痳醉.
목적 평개후조재쌍측로골찬공인류수술마취중적응용효과.방법 선취64례의행쌍측로골찬공인류수술적환자,안조전뇌수궤분조적원칙분위연구조화대조조각32례.량조적마취방법균위전신마취,연구조사용후조적방식통기,대조조사용기관삽관(경구명시)적방식통기.기록량조환자T0(술전)、T1(유도후3 min)、T2(삽기관도관(후조)즉시)、T3(수술개시시)、T4(술필)、T5(발제기관도관(후조)시)적혈압、심솔[MAP、HR]변화급PetCO2(호말이양화탄분압)、SpO2(혈양포화도)적개변,기록수술모시、발제기관도관(혹후조)시、혈관활성약물(여아탁품、마황소)적응용정황급술중시부출현창해、술후유무인부동통등정황.결과 연구조병박분、서분태니급유고추안용량균명현소우대조조[(142±26)mg vs.(180±30)mg,(231±49)μg vs.(292±48)μg,(5±1)mg vs.(8±2)mg],발관시간명현단우대조조[(3.6±0.7)min vs.(9.2±1.1)min],기관도관혹자후조적삽입、발제시연구조MAP화HR균저우대조조,차이균유통계학의의(P＜0.05).연구조발제후조시창해、인후부동통、관도대혈등정황명현감소(3 vs.28;2 vs.13;1 vs.12),술중환자체동화창해등정황명현소우대조조(1 vs.10;0 vs.13),차이균유통계학의의(P＜0.05).결론 쌍측로골찬공외인류수술방치후조통기시일충가행적、유효적전신마취통기방식지일,기조작간역、소수마취약물교소、병발증소,가괄용우쌍측로골찬공외인류수술적마취.
Objective To investigate the application effect of laryngeal mask airway (LMA) in double-side burr hole drainage surgery.Methods 64 patients who were prepared for double-side burr hole drainage surgery were randomly divided into research group (laryngeal mask airway) and control group (tracheal intubation),32 cases in each group.Monitored and recorded the changes of MAP (mean arterial blood pressure),HR (heart rate),SpO2 (pulse oxygen saturation) and PetCO2 (end-tidal carbon dioxide partial pressure) before the operation (T0),3 min after anesthesia induction (T1),at the time of tracheal intubation or laryngeal insertion (T2),at the beginning of operation (T3),at the end of surgery (T4),and at the time of tracheal extubation or laryngeal drawing (T5).Recorded total operation time,extubation or drawing time,the dosage of atropine and ephedrine,complications such as bucking,throat pain,etc.Results The dosages of propofol,remifentanyl,vecuronium and extubation time obviously decreased in research group [(142 ± 26)mg vs.(180 ± 30)mg,(231 ± 49)μg vs.(292 ± 48)μg,(5 ± 1)mg vs.(8 ± 2)mg; (3.6 ± 0.7)min vs.(9.2 ± 1.1) min] (P ＜ 0.05).At T2 and T5,MAP and HR in research group significantly decreased compared with control group (P ＜ 0.05).The incidences ofintraoperation movement and bucking in research group were obviously lower than those in control group (1 vs.10,0 vs.13; P ＜ 0.05).Compared with control group,the incidences of bucking,sore throat and pipeline with blood in research group significantly decreased at T5 (3 vs.28,2 vs.13,1 vs.12; P ＜ 0.05).Conclusions LMA is a feasible and effective way of ventilation in general anesthesia.With the advantages of simple operation,less essential narcotic drug and less complications,LMA does apply to general anesthesia in double-side burr hole drainage surgery.
