SLIPA喉罩与气管插管在全麻乳腺癌根治术中的比较

Comparison of SLIPA Laryngeal Mask with Endotreacheal Intubation in Patients Undergoing Radical Mastectory

目的:观察SLIPA喉罩与气管插管用于全麻乳腺癌根治术对患者血流动力学、血气指标和气道阻力的影响。方法:择期全麻下乳腺癌根治术患者60例,随机均分为SLIPA喉罩组(A组)和气管插管组(B组),分别记录插入喉罩/气管导管前(T0)、后1min(T1)、3min(T2)和拔喉罩/气管导管前(T3)、后1min(T4)、3min(T5)的SBP、DBP、HR和SpO2以及血气指标(pH值、PaO2和PaCO2)。同时在8ml/kg潮气量下监测T1～T3时的平均气道压(Pmean)、气道峰压(Ppeak)和PETCO2;并观察置放通气装置的成功率、术中有无反流误吸情况及术后咽喉部并发症。结果:T1、T3、T4时B组HR明显增快,SBP、DBP明显高于T0时及A组(P<0.05)。A组在T1、T2时的Pmean、Ppeak明显低于B组(P<0.05)。T0～T5时血气指标(pH值、PaO2和PaCO2)两组间差异无显著性(P>0.05)。结论:全麻下SLIPA喉罩通气用于乳腺癌根治术患者应激反应小,并能有效通气,术后咽喉部并发症少。

Objective：To observe the effects of SLIPA laryngeal mask airway with endotreacheal intubation on hemodynamics and airway resistance in patients undergoing radical mastectory.Methods：Sixty patients scheduled for selective radical mastectory under general anesthesia were allocated randomly to either SLIPA group（group A） or endotreacheal intubation group（group B） with mechanial ventilation（n=30,in each group）.SBP,DBP,HR,SpO2 and blood gas（pH,PaO2,PaCO2） were recorded before before intubation（T0）,after intubation at 1min（T1）,at 3min（T2）,before extubation（T3）,after extubation at 1min（T4）,at 3min（T5）.Pmean,Ppeak and PETCO2 were measured at T1～T3 in two groups under the tidal volume in 8ml/kg,respectively.And to observe the success rate of ventilation devices placement in two groups,as well as the availability of intraoperative aspiration of reflux and postoperative throat complications.Results： In group B,SBP,DBP and HR at T1,T3,T4 were significantly higher than at T0 and those in group A（P0.05）.Pmean,Ppeak were significantly lower in group A than those in group B at T1,T2（P0.05）.Blood gas at T0～T5 did not differ between the two groups（P0.05）.Conclusions： SLIPA laryngeal mask contributed less cardiovascular stress,more effective ventilation,and few complications of throat after operation compared to endotracheal intubation technique in patients undergoing radical mastectory.