临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
Journal of Clinical and Experimental Medicine
2015年
17期
1482-1485
,共4页
老年人%腹腔镜%胆囊手术%喉罩麻醉%气管内插管%呼吸功能%循环功能
老年人%腹腔鏡%膽囊手術%喉罩痳醉%氣管內插管%呼吸功能%循環功能
노년인%복강경%담낭수술%후조마취%기관내삽관%호흡공능%순배공능
Elderly%Laparoscopy%Gallbladder operation%Laryngeal mask airway%Endotracheal intubation%Respiratory function%Circu-lation function
目的：探究老年人腹腔镜胆囊手术分别开展喉罩麻醉和气管内插管麻醉对其呼吸及循环功能的影响，并为这类患者临床麻醉方案的最优化选择积累经验。方法选取于2012年4月至2014年5月收治的84例行腹腔镜胆囊摘除术老年患者，利用随机数字表法进行分组，分别设为研究组和对照组，每组各42例。其中对照组开展气管内插管麻醉，研究组则开展喉罩全麻。记录两组患者围手术期各监测时间点的循环、呼吸功能及并发症发生率，并对比分析。结果两组插入前的心率（ HR）及平均动脉压（ MAP）值差异无统计学意义（ P >0.05）；研究组在插入后即刻、插入后3 min、拔除前即刻、拔除后即刻、拔出后3 min的HR及MAP值均低于对照组，差异有统计学意义（ P <0.05）。两组患者在插入前、插入后即刻、拔除后即刻及拔除后3 min的PAW和PETCO2值差异无统计学意义（ P >0.05）；研究组在插入后3 min及拔除前即刻气道压力（PAW）及呼气末二氧化碳分压（PETCO2）差异无统计学意义（ P >0.05）。研究组麻醉期间不良反应发生率低于对照组（16.7%比47.6%），差异有统计学意义（ P <0.05）。结论喉罩麻醉应用于老年人腹腔镜胆囊手术，相较于气管内插管，能有效减轻机体在麻醉操作时的应激反应，利于循环及呼吸功能的稳定性，且安全性可，值得进一步推广。
目的：探究老年人腹腔鏡膽囊手術分彆開展喉罩痳醉和氣管內插管痳醉對其呼吸及循環功能的影響，併為這類患者臨床痳醉方案的最優化選擇積纍經驗。方法選取于2012年4月至2014年5月收治的84例行腹腔鏡膽囊摘除術老年患者，利用隨機數字錶法進行分組，分彆設為研究組和對照組，每組各42例。其中對照組開展氣管內插管痳醉，研究組則開展喉罩全痳。記錄兩組患者圍手術期各鑑測時間點的循環、呼吸功能及併髮癥髮生率，併對比分析。結果兩組插入前的心率（ HR）及平均動脈壓（ MAP）值差異無統計學意義（ P >0.05）；研究組在插入後即刻、插入後3 min、拔除前即刻、拔除後即刻、拔齣後3 min的HR及MAP值均低于對照組，差異有統計學意義（ P <0.05）。兩組患者在插入前、插入後即刻、拔除後即刻及拔除後3 min的PAW和PETCO2值差異無統計學意義（ P >0.05）；研究組在插入後3 min及拔除前即刻氣道壓力（PAW）及呼氣末二氧化碳分壓（PETCO2）差異無統計學意義（ P >0.05）。研究組痳醉期間不良反應髮生率低于對照組（16.7%比47.6%），差異有統計學意義（ P <0.05）。結論喉罩痳醉應用于老年人腹腔鏡膽囊手術，相較于氣管內插管，能有效減輕機體在痳醉操作時的應激反應，利于循環及呼吸功能的穩定性，且安全性可，值得進一步推廣。
목적：탐구노년인복강경담낭수술분별개전후조마취화기관내삽관마취대기호흡급순배공능적영향，병위저류환자림상마취방안적최우화선택적루경험。방법선취우2012년4월지2014년5월수치적84례행복강경담낭적제술노년환자，이용수궤수자표법진행분조，분별설위연구조화대조조，매조각42례。기중대조조개전기관내삽관마취，연구조칙개전후조전마。기록량조환자위수술기각감측시간점적순배、호흡공능급병발증발생솔，병대비분석。결과량조삽입전적심솔（ HR）급평균동맥압（ MAP）치차이무통계학의의（ P >0.05）；연구조재삽입후즉각、삽입후3 min、발제전즉각、발제후즉각、발출후3 min적HR급MAP치균저우대조조，차이유통계학의의（ P <0.05）。량조환자재삽입전、삽입후즉각、발제후즉각급발제후3 min적PAW화PETCO2치차이무통계학의의（ P >0.05）；연구조재삽입후3 min급발제전즉각기도압력（PAW）급호기말이양화탄분압（PETCO2）차이무통계학의의（ P >0.05）。연구조마취기간불량반응발생솔저우대조조（16.7%비47.6%），차이유통계학의의（ P <0.05）。결론후조마취응용우노년인복강경담낭수술，상교우기관내삽관，능유효감경궤체재마취조작시적응격반응，리우순배급호흡공능적은정성，차안전성가，치득진일보추엄。
Objective To explore the effect on the respiration and circulation function with laryngeal mask anesthesia and endotracheal in-tubation anesthesia in the elderly laparoscopic operation,and to accumulate experience for this kind of patients in clinical anesthesia alternatives. Methods 84 cases of laparoscopic cholecystectomy patients form 2012 April to 2014 May were included into this study. Using random number ta-ble method for grouping,they were divided into study group and control group,each group had 42 cases. The control group were carried out endo-tracheal intubation anesthesia. The study group were carried out the laryngeal mask anesthesia. Patients in two groups were recorded in the circula-tion,respiratory function and complications during the operation of each monitoring point in time the incidence,and make a comparison. Results The two groups before insertion of HR and MAP were not statistically significant( P >0. 05). Study group after insertion,removal of 3min,im-mediately after insertion immediately before,immediately after removal,pull out the HR and MAP values of 3min were lower than those of the con-trol group. The difference was statistically significant( P <0. 05). Two groups of patients in the insert,removal immediately and after removal of 3 min PAW and PETCO2 values had no significant difference( P >0. 05). The study group after insertion and removal of 3 min immediately be-fore PAW and PETCO2 values had no significant difference( P >0. 05). The occurrence rate in the research group of anesthetic adverse reactions was 16. 7%(7/42),the control group the incidence of adverse reaction was 47. 6%(20/42). The difference was statistically significant( P <0. 05). Conclusion Laryngeal mask anesthesia in the elderly laparoscopic operation,compared with endotracheal intubation,can effectively re-duce the stress response to anesthesia operation,be conducive to the stability of circulatory and respiratory function,and security. This method is worthy of further promotion.
