经口咽通气道面罩加压给氧在腹腔镜胆囊切除术中的应用

Application of face mask pressurized ventilation through oropharyngeal airway in laparoscopic cholecystectomy

目的：探讨口咽通气道在腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）中应用的有效性和通气效果。方法：选择我院100例择期行LC的患者，ASAⅠ～Ⅱ级，20—76岁，随机分为气管导管组（T组）和口咽通气道组（M组），观察患者入室（T1）、插管前（T2）、插管后（T3）、气腹前（T4）、气腹后5min（T5）、气腹结束后（T6）的HR、BP、SpO2、呼气末二氧化碳分压（PET CO2）和气道峰值压力，在T1、T3和T6分别抽取动脉血进行血气分析。记录气腹时间和麻醉时间及拔管和术后并发症。结果：两组患者一般情况、术中通气情况及血气分析差异均无统计学意义。T组插管时循环系统波动大（P〈0．05），拔管时呛咳发生率高（P〈0．01），术后咽痛率高（P〈0．01）。结论：口咽通气道用于LC简便、实用、微创。

Objective：To discuss the efficacy and venting effect of oropharyngeal airway in laparoscopic cholecystectomy （LC）. Methods：One hundred patients （20-76 years） who would receive selective LC ,ASA Ⅰ -Ⅱ ,were randomly divided into tracheal catheter group （T group） and oropharyngeal airway group（ M group）. HR, BP, SpO2, PETCO2 and peak inspiratory pressure were observed when patients were sent in surgery room （ T1 ）, pre-intubation （ T2 ）, post-intubation （ T3 ）, pre-pneumnperitoneum （ T4 ） , the 5th rain during pneumoperitoneum（ T5 ）, and post-pneumoperitoneum （ T6 ）. Arterial bloods were collected for blood gas analysis at T1 , T3 and T6 , respectively. Time of pneumoperitoneum and anaesthesia, extubation and postoperative complications were recorded. Results： The difference of general state of health, venting during surgery and blood gas analysis between two groups were not statistically significant. Significant fluctuation of circulating system when intubating（ P 〈 0.05 ） , high bucking incidence rate when extubating（ P 〈 0.01 ） and high postoperative pharyngodynia incidence rate （P 〈 0.01 ）were observed in T group. Concluions： Oropharyngeal airway is simple,effective and mini-invasive for LC.