喉罩与气管插管复合硬膜外麻醉对手术患者心血管循环及口腔分泌物量的影响

Comparative analysis of the cardiovascular circulation effects and the amount of oral secretions volume of surgery patients after laryngeal mask and tracheal intubation combined with epidural anesthesia

目的探讨全麻合并连硬外手术中置喉罩和气管内插管对患者心血管反应及口腔分泌物量的影响。方法选择无心血管疾病、无重要脏器疾患、ASAI-Ⅱ级、择期全麻合并连硬外手术患者40例，随机分成两组：喉罩组和插管组，每组20例。记录各组患者置喉罩或气管插管前（T．）、诱导后（L）、1min（L）、3min（T4）、术中（L）、拔罩（管）时（T6）、拔罩（管）后1min（T7）、拔罩（管）后3min（L）的SBP、DBP、HR、Sp02。结果喉罩或气管插管前的SBP、DBP、HR差别不大；拔管T6、T7、T8的SBP、DBP、HR组间比较差异有统计学意义（P〈0．05），插管组T6SBP（138±35）mmHg，DBP（92±16）mmHg，HR（96±19）次／min高于喉罩组T6（P〈0．05）。结论喉罩对患者心血管系统影响小，可以达到与气管插管一样满意的通气效果，具有血流动力学平稳、操作方便、简单、咽部不适、声嘶发生低而且口腔分泌物量少等优点。

Objective To compare the effects of cardiovascular reaction after laryngeal mask and endotracheal intubation in patients of epidural anesthesia combined with surgery and a comparative analysis of the oral secretions volume. Methods Choose elevcitce general anesthesia associated with epidurdl opuo cases. Randomly divided into 2 groups：laryngeal mask airway group and endotracheal intubation set,each group 20 coses. Records before each group of patients with laryngeal mask airway or endotracheal intubation （ T1 ）, after induction （ T2 ）, 1 minute （ T3 ）, 3minnte （ T4 ）, intraoperative （ T5 ）, remove cover （pipes） （ T6 ）, to pull over and over 1 minute （ T7 ） and remove cover （ pipes ） after 3minute（Ts ） SBP, DBP, HR, SpO2. Results Laryngeal mask or tracheal intubation prior to SBP, DBP, HR was not very different. Prior to extubation T6,T7,T8 of the SBP, DBP, HR between the two groups had significant differences The tracheal intubation group showed that the group with more than the laryngeal mask group. Particularly T6 endotracheal intubation group SBP（ 138±35）mm Hg,DBP（92 ± 16）mm Hg,HR（96± 19）/rain showed higher LMA T6 group. Conclusion Laryngeal mask airway affects slightly effect on cardiovascular system in patients. LMA intubation could be achieved with satisfactory ventilation of the same tracheal intubation. LMA with hemodynamic stable, easy to operate, simple, throat discomfort, hoarseness of low. Laryngeal mask airway group was less than the amount of oral secretions endotracheal intubation group and so on.