CAJ | 학술논문

目的：探讨第三代喉罩(PLMA)在腹腔镜妇科手术中应用的安全性。方法60例择期行腹腔镜卵巢囊肿摘除术患者，ASA分级Ⅰ至Ⅱ级，年龄20至50岁，体重45至90kg随机分2组（N＝30），第三代喉罩全麻(A)组,气管插管全麻(B)组；观测记录两组患者插管前、PLMA置入或插管后即刻，PLMA或气管导管取出后1分钟HR、SBp、DBp，SPO2，PETCO2。根据体重选择喉罩型号，根据年龄﹑性别选择气管插管型号。麻醉诱导后置入喉罩、气管导管行机械通气；并经引流管放置胃管，记录喉罩置入次数（气管导管插入次数）观察术中口咽部漏气，低氧血症的发生情况，观察拔除喉罩和气管导管后恶心、呕吐、呛咳、声嘶、咽喉痛、返流误吸情况。结果记学意义（P＞0.05）；两组均无一例发生声嘶，返流误吸。A组三个时间段HR、SBp差异无显著性(P>0.05),B组后两个时间段HR、SBp波动明显差异有显著性(P<0.05)，两组间SPO2和PETCO2无明显差异。结论 PLMA用于妇科腹腔镜手术安全可靠，对血流动力学影响小,安全有效，可避免气管插管引起的并发症，值得推广应用。
목적：탐토제삼대후조(PLMA)재복강경부과수술중응용적안전성。방법60례택기행복강경란소낭종적제술환자，ASA분급Ⅰ지Ⅱ급，년령20지50세，체중45지90kg수궤분2조（N＝30），제삼대후조전마(A)조,기관삽관전마(B)조；관측기록량조환자삽관전、PLMA치입혹삽관후즉각，PLMA혹기관도관취출후1분종HR、SBp、DBp，SPO2，PETCO2。근거체중선택후조형호，근거년령﹑성별선택기관삽관형호。마취유도후치입후조、기관도관행궤계통기；병경인류관방치위관，기록후조치입차수（기관도관삽입차수）관찰술중구인부루기，저양혈증적발생정황，관찰발제후조화기관도관후악심、구토、창해、성시、인후통、반류오흡정황。결과기학의의（P＞0.05）；량조균무일례발생성시，반류오흡。A조삼개시간단HR、SBp차이무현저성(P>0.05),B조후량개시간단HR、SBp파동명현차이유현저성(P<0.05)，량조간SPO2화PETCO2무명현차이。결론 PLMA용우부과복강경수술안전가고，대혈류동역학영향소,안전유효，가피면기관삽관인기적병발증，치득추엄응용。
Objective investigate safety of the third generation laryngeal mask airway for laparoscopic gynecologic surgery anesthesia. Method 60 patients waiting for laparoscopic ovarian cyst resection, with ASA grade I to II, aged 20 to 50, weight 45 to 90kg were randomly divided into 2 groups (N=30), the third generation laryngeal mask airway group (A), tracheal intubation general anesthesia group (B), then observe and record HR、SBp、DBp,SPO2,PETCO2 index before intubation, PLMA imbedding or just after intubation, 1 minute after withdrawal of PLMA or tracheal catheter. According to weight choose type of laryngeal mask airway, and choose tracheal catheter type according to age and sex. After anesthesia induction place LMA and tracheal catheter for mechanical ventilation;and place gastric tube through drainage tube, record placement times of LMA (trachea catheter insertion times). Observe situation of oropharyngeal leak, hypoxemia incidence, and nausea, vomiting, choking cough, hoarseness, sore throat, reflux aspiration after removal of laryngeal mask and tracheal catheter. Result record shows no statistics significance (P>0.05);there are no cases of hoarseness, reflux and aspiration for both groups. There was no significant difference of HR and A (SBp) for three periods for group A(P>0.05), and the latter two periods HR、SBp showed obvious and significant fluctuation(P<0.05). Difference of SPO2 and PETCO2 between two groups showed no significantly different. Conclusion PLMA is safe and reliable for gynecologic laparoscopic surgery for its little influence for hemodynamics, and it can avoid complications caused by tracheal intubation, and is worthy of being spreaded and applied.