CAJ | 학술논문

目的：探讨患儿术中麻醉喉罩及气管插管对于上呼吸道感染的影响，为临床诊治提供参考。方法选取2012年1月－2014年12月100例患儿，均需实施全麻开腹手术，按照麻醉管理方案分为对照组与观察组，各50例，对照组使用气管插管，观察组使用ProSeal喉罩，对比两组患儿不同时间节点心率、术后1 d感染率及感染症状。结果观察组与对照组麻醉前、麻醉诱导后、术中心率对比差异无统计学意义，置入喉罩或气管插管时、拔除喉罩或气管插管时观察组心率分别为（113．59±6．31）、（114．42±8．14）／min ，明显低于对照组，对比差异有统计学意义（ P＜0．01）；对照组感染率为18．00％，明显高于观察组6．00％，对比差异有统计学意义（ P＜0．01），对照组发热、肺部啰音、咳痰液、喘鸣、低氧血症发生率均高于观察组，对比差异有统计学意义（P＜0．05）。结论全麻开腹术中使用喉罩进行气道管理对于患儿刺激性小，利于手术顺利进行，同时术后感染率低，感染症状轻，利于术后恢复。
목적：탐토환인술중마취후조급기관삽관대우상호흡도감염적영향，위림상진치제공삼고。방법선취2012년1월－2014년12월100례환인，균수실시전마개복수술，안조마취관리방안분위대조조여관찰조，각50례，대조조사용기관삽관，관찰조사용ProSeal후조，대비량조환인불동시간절점심솔、술후1 d감염솔급감염증상。결과관찰조여대조조마취전、마취유도후、술중심솔대비차이무통계학의의，치입후조혹기관삽관시、발제후조혹기관삽관시관찰조심솔분별위（113．59±6．31）、（114．42±8．14）／min ，명현저우대조조，대비차이유통계학의의（ P＜0．01）；대조조감염솔위18．00％，명현고우관찰조6．00％，대비차이유통계학의의（ P＜0．01），대조조발열、폐부라음、해담액、천명、저양혈증발생솔균고우관찰조，대비차이유통계학의의（P＜0．05）。결론전마개복술중사용후조진행기도관리대우환인자격성소，리우수술순리진행，동시술후감염솔저，감염증상경，리우술후회복。
OBJECTIVE To explore the influence of the intraoperative anesthesia laryngeal mask and endotracheal intubation on upper respiratory tract infections in the children so as to provide guidance for the clinical diagnosis and treatment .METHODS A total of 100 children who were treated from Jan 2012 to Dec 2014 were enrolled in the study ,all the subjects needed to receive general anesthesia laparotomy ,the enrolled children were divided into the control group and the observation group according to the anesthesia management program ,with 50 cases in each;the control group was treated with endotracheal intubation ,while the observation group was given the ProSeal la‐ryngeal mask;the heart rates ,incidence of infections one day after surgery ,and symptoms of infections at differ‐ent time points were observed and compared between the two groups .RESULTS There was no significant difference in the intraoperative heart rate between the observation group and the control group before and after the induction of anesthesia;the heart rate at placement of laryngeal mask or endotracheal intubation was (113 .59 ± 6 .31)/min in the observation group ,significantly lower than that in the control group;the heart rate at removal of laryngeal mask or endotracheal tubes was (114 .42 ± 8 .14)/min in the observation group ,significantly lower than that in the control group(P<0 .01) .The infection rate of the control group was 18 .00% ,significantly higher than 6 .00% of the observation group(P<0 .01) .The incidence rates of fever ,pulmonary rales ,expectoration ,wheezing ,and hy‐poxemia of the control group were significantly higher than those of the observation group ( P < 0 .05 ) . CONCLUSION The use of laryngeal mask for the airway management of the children undergoing general anesthesia laparotomy is conducive to the smooth of the surgery and leads to less irritations ,with the incidence of postopera‐tive infections low ,the symptoms of infections mild ,and it is helpful for the postoperative recovery .