摘要
目的探讨Proseal型喉罩置入与气管插管在腹腔镜阑尾切除术中的应用比较。方法选取2015年2月-2017年2月于本院行腹腔镜阑尾切除术患者200例,根据辅助呼吸方式不同分为喉罩组和插管组,各100例,插管组给予气管插管辅助呼吸,喉罩组给予Proseal型喉罩置入辅助呼吸。观察两组患者不同时间点平均气道压(Pmean)、气道峰压(Ppeak)、呼气末二氧化碳分压(P_(ET)CO_2)、皮质醇、心钠素的值及并发症发生情况。结果喉罩组Pmean、Ppeak的值于T_1、T_2、T_3、T_4均低于插管组相应时间点,差异有统计学意义(P<0.05),P_(ET)CO_2的值于T_1、T_2、T_3、T_4两组患者相应时间点比较,差异均无统计学意义(P>0.05);喉罩组皮质醇含量于T_1、T_2、T_3、T_4均低于插管组相应时间点,差异有统计学意义(P<0.05);心钠素的含量于T_2、T_4喉罩组低于插管组,差异有统计学意义(P<0.05);喉罩组反流误吸、拔管呛咳、咽喉部疼痛发生低于插管组,差异有统计学意义(P<0.05)。结论 Proseal型喉罩置入较气管插管在腹腔镜阑尾切除术中,患者应激反应更小,更有利于改善呼吸功能,术后咽喉部并发症更低,提高了患者围手术期安全性,值得临床作进一步推广。
Objective To discuss the application comparson of proseal laryngeal mask and tracheal intubation used for laparoscopic cholecystectomy. Methods 200 cases of laparoscopic appendectomy in our hospital from February 2015 to February 2017 were selected and divided into laryngeal mask group and intubation group according to the auxiliary breathing methods, 1OO cases in each group, the intubation group was given tracheal intubation assisted respiration, and the laryngeal mask group was given Proseal type laryngeal mask for auxiliary breathing. The average airway pressure （Pmean）, airway peak pressure （Ppeak）, end expiratory carbon dioxide pressure （PETCO2 ）, cortisol and atrial natriuretic peptide were observed at different time points of the two groups. Results At the time of the T1, T2, T3 and T4, Pmean, Ppeak value of the observation group was significantly lower than the control group, there was statistically significant difference （!〈0.05）, PETCO2 value of two groups had no significant difference （P〉0.05）. Cortisol of the observation group was significantly lower than the control group, there was statistically significant difference （P〈0.05）. At the time of the T2 and T4, heart sodium element content of the observation group was significantly lower than the control group, there was statistically significant difference （P〈0.05）. Incidence of reflux aspiration, decannulation choking cough and throat pain of the observation group was significantly lower than the control group, there was statistically significant difference （P〈0.05）. Conclusion Compared with tracheal intubation, proseal laryngeal mask used for laparoscopic cholecystectomy has smaller stress response and improve the respiratory function with lower postoperative throat complications, it＇s worth for further clinical promotion.
作者
李大桁
何海燕
颜振艺
梁广彬
葛凤敏
LI Da-heng;HE Haiyan;YAN Zhenyi;LIANG Guangbin;GE Fengmin(Department of Anesthesiology,Affiliated Hospital of Guangdong Medical University 524001.)
出处
《江西医药》
CAS
2018年第7期676-679,共4页
Jiangxi Medical Journal
