CAJ | 학술논문

目的：探讨SupremeTM喉罩在喉癌患者气管切开术中应用的可行性和安全性,以及对患者血流动力学、SPO2以及血糖的影响,评价SupremeTM喉罩在喉癌手术中的应用价值°方法选择50例ASAⅠ~Ⅲ级的男性喉癌Ⅱ、Ⅲ期择期手术病人,随机分为喉罩麻醉气管切开组(L组﹚和局部浸润麻醉气管切开组(T组﹚,每组25例°观察入室时(T1﹚、气管切开开始1 min (T2﹚,气管导管置入1 min(T3﹚以及喉癌根治术后30 min(T4﹚4个时点的MAP、HR、SPO2变化以及血糖水平,同时统计气管切开所用时间°结果T组在T2(112.33±10.76vs75.05±6.34﹚、T3(119.45±9.87vs75.37±6.56﹚的MAP显著高于L组,T组在T2(115.68±10.45vs80.32±7.23)、T3(110.56±9.94vs83.43±6.68)的 HR显著高于L组,T组在T3(8.56±1.54vs6.23±1.32)、T4(9.07±1.37vs4.24±0.54)血糖高于L组,T组所用气管切开时间高于L组(19.3±2.9vs14.5±3.1)°结论与局部浸润麻醉下气管切开置入气管插管通气相比,SupremeTM喉罩麻醉下气管切开对患者血流动力学干扰小,导致的血糖升高反应轻,同时能有效保证通气,缩短手术时间°
목적：탐토SupremeTM후조재후암환자기관절개술중응용적가행성화안전성,이급대환자혈류동역학、SPO2이급혈당적영향,평개SupremeTM후조재후암수술중적응용개치°방법선택50례ASAⅠ~Ⅲ급적남성후암Ⅱ、Ⅲ기택기수술병인,수궤분위후조마취기관절개조(L조﹚화국부침윤마취기관절개조(T조﹚,매조25례°관찰입실시(T1﹚、기관절개개시1 min (T2﹚,기관도관치입1 min(T3﹚이급후암근치술후30 min(T4﹚4개시점적MAP、HR、SPO2변화이급혈당수평,동시통계기관절개소용시간°결과T조재T2(112.33±10.76vs75.05±6.34﹚、T3(119.45±9.87vs75.37±6.56﹚적MAP현저고우L조,T조재T2(115.68±10.45vs80.32±7.23)、T3(110.56±9.94vs83.43±6.68)적 HR현저고우L조,T조재T3(8.56±1.54vs6.23±1.32)、T4(9.07±1.37vs4.24±0.54)혈당고우L조,T조소용기관절개시간고우L조(19.3±2.9vs14.5±3.1)°결론여국부침윤마취하기관절개치입기관삽관통기상비,SupremeTM후조마취하기관절개대환자혈류동역학간우소,도치적혈당승고반응경,동시능유효보증통기,축단수술시간°
Objective To evaluate the application value of LMA SupremeTM in laryngeal cancer surgery by investigating the feasi_bility and safety of LMA SupremeTM used in tracheotomy for laryngeal cancer patients and its effect on the hemodynamics, SPO2 and blood sugar of the patients. Methods Fifty male cases with laryngeal cancer stageⅡ or Ⅲ, ASAⅠ-Ⅲ grade, undergoing se_lective tracheotomy surgery were selected and randomly divided into 2 groups, Laryngeal mask anesthesia tracheotomy with LMA SupremeTM group (L group) and Local infiltration anesthesia tracheotomy group (T group), each group with 25 cases. Changes of MAP, HR and SPO2 and the blood glucose levels of the patients were observed at the time of entering the operating room (T1), 1min after tracheotomy (T2), 1min after tracheal catheter (T3) and 30min after laryngeal cancer radical surgery(T4). And the time spent on the tracheotomy was recorded. Results The MAP of T group was significantly higher than that of L group at the time point of T2(112.33±10.76 vs. 75.05±6.34) and T3(119.45±9.87 vs. 75.37±6.56), and HR of the T group was obviously higher than that of L group at the time point of T2 (115.68±10.45 vs. 80.32±7.23), and T3 (110.56±9.94 vs. 83.43±6.68);the blood glucose level of T group was higher than that of L group at the time point of T3(8.56±1.54 vs. 6.23±1.32), and T4(9.07±1.37 vs. 4.24±0.54). T group spent more time on tracheotomy than L group (19.3±2.9 vs. 14.5±3.1). Conclusion Compared with local infiltration anesthesia tra_cheotomy, patient with laryngeal mask anesthesia tracheotomy with LMA SupremeTM has more stable hemodynamic, better glycemic levels, and shorter operative time based on ensuring the effective ventilation.