中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
9期
1323-1326
,共4页
李继周%高彦东%高静%郭宇峰%边步荣%薛利军%刘波
李繼週%高彥東%高靜%郭宇峰%邊步榮%薛利軍%劉波
리계주%고언동%고정%곽우봉%변보영%설리군%류파
子宫切除术%腹腔镜检查%肥胖%喉罩麻醉,表面
子宮切除術%腹腔鏡檢查%肥胖%喉罩痳醉,錶麵
자궁절제술%복강경검사%비반%후조마취,표면
Hysterectomy%Laparoscopy%Obesity%Laryngeal mask anesthesia,surface
目的 观察镇静镇痛口咽表面麻醉清醒状态下置入喉罩,用于肥胖患者腹腔镜子宫切除术中气道管理的临床效果.方法 收集行腹腔镜子宫切除术的肥胖患者60例,按随机数字表法分为气管插管组(ET组,n=30),喉罩组(LMA组,n=30),观察术前并存疾病、麻醉用药、术中生命体征变化,气腹后60 min的气道峰压(Paw)、血气;苏醒时间;并发症发生情况等.结果 气腹后60 min,ET组MAP、HR、Paw、SpO2分别为(114.6±22.4) mmHg、(108.2±19.6)次/min、(25.4±3.1) mmHg、(96.1±1.2)％,LMA组分别为(97.5±20.8) mmHg、(86.5±20.7)次/min、(22.6±3.7) mmHg、(98.9±0.8％),两组差异均有统计学意义(均P＜0.05);ET组血气pH、PaO2、PaCO2、BE分别为(7.34±0.05)、(177.5±44.5) mmHg、(42.6±6.1)mmHg、(-4.9±0.8 mmol/L),LMA组分别为(7.38±0.05)、(216.7±46.6) mmHg、(38.4±5.5) mmHg、(-3.1±0.6) mmol/L,两组差异均有统计学意义(均P＜0.05);困难气道、急症气道等并发症发生情况:ET组23例次占77％,LMA组10例次占30％,两组差异有统计学意义(P＜0.05).结论 镇静镇痛表面麻醉清醒状态下置入喉罩通气,用于肥胖患者腹腔镜子宫切除术优于快诱导气管插管,易于维持血流动力学及血气的稳定,能有效预防麻醉诱导和拔管期的困难气道、急症气道,术后恢复平稳,并发症少.
目的 觀察鎮靜鎮痛口嚥錶麵痳醉清醒狀態下置入喉罩,用于肥胖患者腹腔鏡子宮切除術中氣道管理的臨床效果.方法 收集行腹腔鏡子宮切除術的肥胖患者60例,按隨機數字錶法分為氣管插管組(ET組,n=30),喉罩組(LMA組,n=30),觀察術前併存疾病、痳醉用藥、術中生命體徵變化,氣腹後60 min的氣道峰壓(Paw)、血氣;囌醒時間;併髮癥髮生情況等.結果 氣腹後60 min,ET組MAP、HR、Paw、SpO2分彆為(114.6±22.4) mmHg、(108.2±19.6)次/min、(25.4±3.1) mmHg、(96.1±1.2)％,LMA組分彆為(97.5±20.8) mmHg、(86.5±20.7)次/min、(22.6±3.7) mmHg、(98.9±0.8％),兩組差異均有統計學意義(均P＜0.05);ET組血氣pH、PaO2、PaCO2、BE分彆為(7.34±0.05)、(177.5±44.5) mmHg、(42.6±6.1)mmHg、(-4.9±0.8 mmol/L),LMA組分彆為(7.38±0.05)、(216.7±46.6) mmHg、(38.4±5.5) mmHg、(-3.1±0.6) mmol/L,兩組差異均有統計學意義(均P＜0.05);睏難氣道、急癥氣道等併髮癥髮生情況:ET組23例次佔77％,LMA組10例次佔30％,兩組差異有統計學意義(P＜0.05).結論 鎮靜鎮痛錶麵痳醉清醒狀態下置入喉罩通氣,用于肥胖患者腹腔鏡子宮切除術優于快誘導氣管插管,易于維持血流動力學及血氣的穩定,能有效預防痳醉誘導和拔管期的睏難氣道、急癥氣道,術後恢複平穩,併髮癥少.
목적 관찰진정진통구인표면마취청성상태하치입후조,용우비반환자복강경자궁절제술중기도관리적림상효과.방법 수집행복강경자궁절제술적비반환자60례,안수궤수자표법분위기관삽관조(ET조,n=30),후조조(LMA조,n=30),관찰술전병존질병、마취용약、술중생명체정변화,기복후60 min적기도봉압(Paw)、혈기;소성시간;병발증발생정황등.결과 기복후60 min,ET조MAP、HR、Paw、SpO2분별위(114.6±22.4) mmHg、(108.2±19.6)차/min、(25.4±3.1) mmHg、(96.1±1.2)％,LMA조분별위(97.5±20.8) mmHg、(86.5±20.7)차/min、(22.6±3.7) mmHg、(98.9±0.8％),량조차이균유통계학의의(균P＜0.05);ET조혈기pH、PaO2、PaCO2、BE분별위(7.34±0.05)、(177.5±44.5) mmHg、(42.6±6.1)mmHg、(-4.9±0.8 mmol/L),LMA조분별위(7.38±0.05)、(216.7±46.6) mmHg、(38.4±5.5) mmHg、(-3.1±0.6) mmol/L,량조차이균유통계학의의(균P＜0.05);곤난기도、급증기도등병발증발생정황:ET조23례차점77％,LMA조10례차점30％,량조차이유통계학의의(P＜0.05).결론 진정진통표면마취청성상태하치입후조통기,용우비반환자복강경자궁절제술우우쾌유도기관삽관,역우유지혈류동역학급혈기적은정,능유효예방마취유도화발관기적곤난기도、급증기도,술후회복평은,병발증소.
Objective To observe the curative effects of applying laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients.Methods 60 cases of obese patients who underwent total laparoscopic hysterectomy were collected and were randomly divided into,the Endotracheal intubation (ET) group(n =30) and the laryngeal mask (LMA) group (n =30).The pre-operative co-existent diseases,applications of analgesia and intra-operative vital signs,the peak airway waves (Paw) 60min after pneumoperitoneum,blood gas;revival time;the incidences of complications were observed.Results 60min after pneumoperitoneum,MAP,HR,Paw and SpO2 values were:ET group:[(114.6 ± 22.4) mmHg,(108.2 ± 19.6) times/min,(25.4 ± 3.1) mmHg,(96.1 ± 1.2％)] LMA group:[(97.5 ±20.8)mmHg,(86.5 ±20.7) times/min,(22.6 ±3.7)mmHg,(98.9 ±0.8％)].The difference was statistically significant (P ＜ O.05);The blood gas analysis,PH,PaO2,PaCO2 and BE values are:ET group:[(7.34 ± 0.05),(177.5 ± 44.5) mmHg,(42.6 ± 6.1) mmHg,(-4.9 ± 0.8) mmol/L],LMA group:[(7.38 ± 0.05),(216.7 ± 46.6) mmHg,(38.4 ± 5.5) mmHg,(-3.1 ± 0.6) mmol/L].The difference was statistically significant (P ＜ 0.05);the status of complications:23 cases in ET group,accounting for 77％,10 cases in LMA group,accounting 30％,presenting significant differences (P ＜ 0.05).Conclusion The application of laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients facilitated the maintaining the stability of hemodynamics and blood gas,resulted in smooth post-anesthesia recovery and fewer complications.
