喉罩在妇科腹腔镜手术中的应用

Application of laryngeal mask airway in gynecological laparoscopic surgery

目的:比较喉罩与气管导管对患者血流动力学的影响,探讨喉罩在妇科腹腔镜手术中的作用。方法:选择40例ASAⅠ、Ⅱ级择期行妇科腹腔镜手术的患者,随机分为喉罩组和气管导管组。比较麻醉诱导前(T0)、插气管导管或喉罩前(T1)、插气管导管或喉罩时(T2)、气腹开始时(T3)、术毕拔气管导管或喉罩时(T4)患者的SBP、DBP、HR、SpO2。分析术中的不良反应及术后咽喉部的并发症。结果:①与T0比较,在T2时气管导管组SBP、HR明显升高(P<0.05),T3、T4时气管导管组SBP明显升高(P<0.05),T3时HR下降(P<0.05)。②T2时喉罩组SBP、DBP、HR均明显低于气管导管组(P<0.05)。③喉罩组术后咽喉部疼痛的发生率低于气管导管组(P<0.05)。结论:喉罩置入时引起的心血管反应轻微,有利于维持血流动力学的平稳,术后并发症少。

Objective： Exploring application of laryngeal mask airway（LMA） in gynecological laparoscopic surgery by comparing the effects of laryngeal mask and endotracheal tube on hemodynamics in patients.Methods： 40 American standards association（ASA） classⅠ~Ⅱ patients who got gynecological laparoscopic procedures,were randomly assigned to the LMA group and the endotracheal intubation（EI） group.SBP,DBP,HR and the SpO2 were measured before the induction of anesthesia（T0）,before tracheal intubation（T1）,immediately after tracheal intubation（T2）,at the beginning of the pneumoperitoneum（T3） and immediately after tracheal extubation（T4）.The intraoperative adverse events and postoperative throat complications were analyzed.Results： In the EI group,SBP and HR at T2 were significantly higher than those at T0（P〈0.05）,and the same as SBP at T3 and T4.However,HR at T3 was significantly lower than that at T0（P〈0.05）.Compared with EI group,SBP,DBP,and HR significantly decreased in the LMA group at T2（P〈0.05）.The incidence rate of postoperative sore throat in the LMA group were less than the EI group（P〈0.05）.Conclusion： Laryngeal mask airway is beneficial to maintain stable hemodynamics for less cardiovascular response,and with fewer postoperative complications.