SLIPA喉罩与气管插管全麻在腹腔镜胆囊切除术中的对比应用

Comparison of SLIPA Laryngeal Mask Airway and Tracheal Intubation in the Laparoscopic Cholecystectomy under General Anesthesia

目的：观察SLIPA喉罩与气管插管用于腹腔镜胆囊切除术对心血管和气道反应的影响。方法：选择60例择期全麻下腹腔镜胆囊切除术患者，ASA分级Ⅰ～Ⅱ，随机分为SLIPA喉罩组（s组）与气管插管组（T组），每组30例。全麻诱导后分别记录插管（罩）前（TO）、插管（罩）后即刻（T1）、插管（罩）后10rain（T2）、手术结束时（T3）、拔管（罩）后即刻（T4），心率（HR）、平均动脉压（MAP）变化值。同时记录气腹前、气腹即刻、气腹后10min及拔管（罩）前的平均气道压（Pmean、气道峰压（Ppeak、呼吸末二氧化碳分压（PetCO2）的变化值。观察喉罩一次置入成功率，术中术后返流误吸、声嘶，咽痛、口腔黏膜损伤情况。结果：与S组比较，T组在T1、T3、T4各时点HR增快、MAP增高，且差异有统计学意义（P〈0．05）。气腹后两组Pmean、Ppeak较气腹前明显增加（P〈0．05），而S组气腹后Pmean、Ppeak低于T组（P〈0．05），气腹后两组PetCO2均升高，两组比较差异无统计学意义（P〉0．05）。术后S组声嘶较T组明显减少（P〈0．05），但咽痛S组显著增加（P〈0．05）。结论：SLIPA喉罩用于腹腔镜胆囊切除术安全简便，降低应激反应，减少术后咽部并发症。

Objective ：To observe the effect of SLIPA laryngeal mask airway and tracheal intubation on cardiovascular and airway response.Methods ： A total of sixty general anesthesia patients at 1-2 stage of ASA were randomly divided into SLIPA laryngeal mask group（Group S） and tracheal intubation group（Group T）.Heart rate（HR） and Mean arterial pressure（MAP） were recorded at 5 pionts ： Before intubation or masking（T0）, immediate（T1）, 10 min（T2） after intubation, at the end of operation（T3）, immediate（T4） after extubation, and Pmean, Ppeak and PetCO2 were measured at before aeroperitoneum, immediate aeroperitoneum, 10 min after aeroperitoneum and before extubation.Observation laryngeal mask a placement of success rate. The availability of intraoperative aspiration of reflux, cough, sore throat, hoarseness, oral mucosal injury were recorded.Results ：In group T, HR, MAP at T1, T3, T4 higher than at the same time points in group S（P〈0.05） ; Pmean, Ppeak were significant.higher at after aeroperitoneum than before aeroperitoneum in T group（P〈0.05）, while compared with group T, Pmean, Ppeak significant low in group S after aeroperitoneum.PetCO2 at after aeroperitoneum was higher than before aeroperitoneum in tow groups, there were no significant differences in PetCO2 between two groups（P〉0.05）.S group hoarseness decreased obviously after operation than in T group （P〈0.05）, but the sore throat S group increased significantly（P〈0.05）.Conclusion ：The SLIPA laryngeal mask airway in laparoscopic cholecystectomy is safe and simple, reduces stress reaction and postoperative pharyngeal complications.