摘要
目的探讨喉罩联合胸椎神经旁阻滞在单孔胸腔镜肺叶切除术的应用。方法选取锦州医科大学附属第一医院接受单孔胸腔镜治疗的患者62例,随机数字表法分成两组,各31例,即DL组(双腔支气管插管)和LM组(喉罩联合胸椎旁神经阻滞),比较两组入室(T0)、麻醉诱导(T1)、插管(T2)、切皮(T3)、切除肺标本(T4)、拔管(T5)的血流动力学波动情况、拔管(喉罩)时间、麻醉复苏室停留时间、术野满意度情况、术中有无咳嗽、术后有无咽喉痛、术后有无肺部感染及术后住院时间。结果两组的平均动脉压在T0时刻差异无统计学意义(P>0.05),DL组的平均动脉压和心率在T2、T3、T5时刻显著高于LM组(P<0.05);DL组的平均动脉压在T0时刻显著高于T1、T4时刻,显著低于T2时刻(P<0.05);DL组的心率在T0时刻显著高于T1时刻(P<0.05);T1时刻的平均动脉压显著低于T2、T3、T5时刻(P<0.05);T1时刻的心率显著低于T2、T5时刻(P<0.05);LM组平均动脉压和心率在T0时刻显著高于T1~T5时刻(P<0.05);T1时刻的平均动脉压显著高于T2~T5时刻(P<0.05);T1时刻的心率显著高于T3时刻(P<0.05);T3时刻DL组脉搏氧饱和度显著低于LM组(P<0.05);LM组拔喉罩时间、PACU停留时间及术后住院时间明显短于DL组(P<0.05);两组术野满意度、术中咳嗽情况及术后肺部感染情况差异统计学意义(P>0.05);DL组术后咽喉痛发生率明显高于LM组(P<0.05)。结论喉罩联合胸椎旁神经阻滞在单孔胸腔镜肺叶楔形切除术中较经典的双腔支气管插管全麻血流动力学更平稳,术后恢复更快,更加符合ERAS理念。
Objective To investigate the application of laryngeal mask combined with thoracic paravertebral block in thoracic surgery.Methods Sixty-two patients who received single-port thoracoscopic treatment in our hospital were selected and divided into two groups by random number table method,and in each group there were thirty-one patients,namely DL group(double-lumen bronchial cannula)and LM group(laryngeal mask combined with thoracic paravertebral block).The hemodynamic fluctuations in terms of entry to operating room(T0),induction of anesthesia(T1),intubation(T2),skin resection(T3),lung specimen resection(T4),and after extubation(T5),extubation(laryngeal mask)time,length of stay in PACU,the satisfaction of operative field,intraoperative cough,postoperative sore throat,postoperative pulmonary infection and postoperative hospital stay were compared between the two groups.Results The mean arterial pressure of the two groups had no significant difference at T0(P>0.05),but the mean arterial pressure and heart rate of the DL group were significantly higher than those of the LM group at T2,T3 and T5(P<0.05);the mean arterial pressure of DL group at T0 was significantly higher than that at T1 and T4,and significantly lower than that at T2(P<0.05);the heart rate of DL group at T0 moment was significantly higher than that at T1 moment(P<0.05);the mean arterial pressure at T1 was significantly lower than that at T2,T3 and T5(P<0.05);the heart rate at T1 was significantly lower than that at T2 and T5(P<0.05);the mean arterial pressure and heart rate of LM group were significantly higher at T0 moments than at T1-T5 moments(P<0.05);the mean arterial pressure at T1 was significantly higher than that at T2-T5(P<0.05);the heart rate at T1 was significantly higher than that at T3(P<0.05);pulse oxygen saturation in DL group at T3 was significantly lower than that in LM group(P<0.05);the duration of laryngeal mask extraction,PACU residence time and postoperative hospital stay in LM group were significantly shorter than those in DL group
作者
周瑞
尚游
吴巧玲
Zhou Rui;Shang You;Wu Qiaoling(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)
出处
《锦州医科大学学报》
CAS
2024年第1期84-89,共6页
Journal of Jinzhou Medical University
基金
辽宁省科学技术计划项目,项目编号:2021-MS-355。
关键词
胸椎旁阻滞
喉罩
胸腔镜肺叶切除术
加速康复外科
thoracic paravertebral block
laryngeal mask
thoracic surgery
enhanced recovery after surgery
