显微喉镜手术中三种麻醉方法的选择

Choices of Three Anesthetic Methods for Microlaryngoscopic Surgery

目的 探讨支撑喉镜下喉显微手术对麻醉方法的选择。方法 应用带气囊导管 (F2 4)气管内插管麻醉 (A组 )、不带气囊小导管 (F16 )气管内插管并高频喷射给氧麻醉 (B组 )和强化表面麻醉 (C组 )三种麻醉方法分别对 319例喉部良性增生性疾病患者行显微喉镜手术。并对三种不同麻醉方法手术中的效果和并发症进行对比观察。结果 发现三种麻醉方法的并发症发生率、血气和心血管功能变化等相互比较无显著性差异 (P >0 .0 5 ) ;而手术成功率和治愈率AB两组比较无显著性差异 (P >0 .0 5 ) ,AC和BC两组间比较有显著性差异 (P <0 .0 5 )。结论 三种麻醉方法各有其优缺点 ,不能相互取代 。

Objective To investigate the selection of three anesthetic methods for laryngeal microsurgery under suspension laryngoscope. Methods 319 cases of laryngeal innocent hypertrophic disease were treated by microlaryngoscopic surgery with three methods of ansethesia that compound verous anesthesia with intratracheal intubation with balloon catheter (group A) or without balloon catheter in high frequency jet ventilation(HFJV) (group B) and surface anesthesia of the pharyngeal and laryngeal mucous membrane (group C) were applied. The effect and complication of three anesthetic methods are compared. Results There was no significant difference between group A,B and C in complications and the change of the cardiovascular functions and SpO 2, PaCO 2 ( P >0.05) also befween group A and B in the successful rate of the operations and the cure rate( P >0.05), but there was significant difference between group B and C and group A and C( P <0.01).Conclusion\ Each anesthetic method has its advantage. Although group A and B had more merits than group C, but group C could not be replaced by group A and B. We consider that these three anesthetic methods should be flexibly adopted in accordance with the patients and the hospital's condition.