不留置鼻胃管联合喉罩麻醉在腹腔镜胆囊切除术中的应用

The application of non-nasogastric decompression with laryngeal mask anaesth in laparoscopic cholecystectomy

目的探讨不留置鼻胃管联合喉罩麻醉在腹腔镜胆囊切除术中的应用效果。方法 2008年3~8月在全麻下行腹腔镜胆囊切除术的患者302例,随机分成A、B两组,A组采用传统术式,B组采用不留置鼻胃管联合喉罩麻醉的方法,比较两组手术方式、手术时间、术后排气时间、心肺并发症、C-反应蛋白、降钙素原以及术后恶心、呕吐、咽痛、声嘶等症状发生情况。结果两组患者均治愈,无胆漏、黄疸、腹腔出血及腹腔感染等并发症发生。两组在手术方式、手术时间、术后排气时间、心肺并发症方面差异无统计学意义;而A组与B组比较,C-反应蛋白、降钙素原值明显升高,伴有恶心、呕吐、咽痛、声嘶症状的患者明显增多,差异有统计学意义。结论基于快速康复外科理念,将不留置鼻胃管联合喉罩麻醉的方法应用于腹腔镜胆囊切除术中是安全有效的。

Objective To investigate the value of non-nasogastric decompression with laryngeal mask anaesth applied in laparoscopic cholecystectomy.Methods From March 2008 to August,302 patients were treaded by laparoscopic cholecystectomy under general anesthesia,randomly divided into A and B groups,the patients in group A used traditional method,and group B used the method of non-nasogastric decompression with laryngeal mask anaesth,observed operation methods,operation time,gut function,C-reactive protein,procalcitonin,postoperative complications of the two groups.Results All the patients were cured without complications in abdomen.The C-reactive protein,procalcitonin and postoperative main complaints of patients of group A were worse compared with those of group B,while the postoperative complications,operation methods,operation time and gut function of the two groups made no difference.Conclusions Non-nasogastric decompression with laryngeal mask anaesth applied in laparoscopic cholecystectomy is safe and effective.