摘要
目的研究全身麻醉(简称全麻)喉罩通气在俯卧位胸腰椎骨折内固定手术中的应用价值。方法收集2017年2月至2020年3月该院收治的95例全麻俯卧位下行胸腰椎骨折内固定术的患者,按照气道管理方式不同分为喉罩通气组(L组)48例、气管插管通气组(T组)47例,比较两组麻醉效果、血流动力学、通气效果及不良反应。结果L组苏醒时间、拔管时间短于T组(P<0.05)。插管/罩即刻(T1)、插管/罩后1 min(T2)、插管/罩后5 min(T3)、术后恢复室拔管/罩(T4)时,L组心率(HR)低于T组(P<0.05);T1、T2、T4时,L组收缩压(SBP)低于T组(P<0.05);两组各时间点脉搏血氧饱和度(SpO_(2))比较,差异均无统计学意义(P>0.05)。L组俯卧位后,气道密封压下降(P<0.05),俯卧位即时呼气末二氧化碳分压(PetCO_(2))升高(P<0.05),但拔出喉罩前与仰卧位时PetCO_(2)比较差异无统计学意义(P>0.05)。L组不良反应总发生率为8.33%,低于T组的29.79%(P<0.05)。结论全麻喉罩通气使用于俯卧位胸腰椎骨折内固定术中,有利于维持患者血流动力学稳定,缩短苏醒时间及拔管时间,且通气效果佳,并发症少。
Objective To study the application value of laryngeal mask ventilation under general anesthesia in internal fixation of thoracolumbar fracture in prone position.Methods Ninety-five patients with thoracolumbar fracture internal fixation under general anesthesia in prone position in this hospital from February 2017 to March 2020 were collected and divided into the laryngeal mask ventilation group(L group,48 cases)and tracheal intubation ventilation group(T group,47 cases)according to different airway management methods.The effects of anesthesia,hemodynamics,ventilation and adverse reactions were compared between the two groups.Results The recovery time and extubation time of the L group were shorter than those of the T group(P<0.05).The heart rate(HR)at the time of intubation/mask(T1),1 min(T2),5 min(T3)after intubation/mask,and extubation/mask(T4)after operation in the L group was lower than that in T group(P<0.05).The systolic blood pressure(SBP)at T1,T2 and T4 in the L group was lower than that in the T group(P<0.05).There was no statistically significant difference in SpO_(2) at each time point between the two groups(P>0.05).After prone position,the airway sealing pressure in the L group was decreased and end-expiratory partial pressure of carbon dioxide(PetCO_(2))was increased(P<0.05),but there was no significant difference between before the laryngeal mask was removed and in the supine position(P>0.05).The total incidence rate of adverse reactions in the L group was 8.33%,which was lower than 29.79%in the T group(P<0.05).Conclusion The use of laryngeal mask ventilation under general anesthesia in prone thoracolumbar fracture internal fixation is conducive to maintain the hemodynamic stability,shorten the awakening time and extubation time of the patients,moreover which has good ventilation effect and less complications.
作者
桂新星
刘荣
王敏华
艾金莲
肖金辉
GUI Xinxing;LIU Rong;WANG Minhua;AI Jinlian;XIAO Jinhui(Department of Anesthesiology,Yingtan Medical District,908 Hospital of PLA Joint Logistic Support Force,Yingtan,Jiangxi 335000,China)
出处
《检验医学与临床》
CAS
2022年第4期447-450,共4页
Laboratory Medicine and Clinic
基金
江西省鹰潭市科技计划项目(YKZ2019018)。
关键词
全身麻醉
喉罩通气
俯卧位
胸腰椎骨折
内固定术
general anesthesia
laryngeal mask ventilation
prone position
thoracolumbar fracture
internal fixation
