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第三代喉罩(PLMA)和I-gel喉罩对腹腔镜胆囊切除术呼吸力学影响的比较 被引量:7

Comparison of the influence of third generation Pro Seal laryngeal mask airway(PLMA) and I-gel laryngeal mask airway on respiratory mechanics during laparoscopic cholecystectomy
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摘要 目的比较第三代喉罩(Pro Seal laryngealmask airway,PLMA)和I-gel喉罩在腹腔镜胆囊切除手术中对患者呼吸力学产生的影响。方法:选择在全身麻醉下择期行腹腔镜胆囊切除术患者68例,随机分为PLMA组和I-gel组,分别在手术中插入PLMA喉罩和I-gel喉罩进行麻醉。观察并记录两组患者的呼吸力学指标,并进行比较。结果 I-gel组患者的动态顺应性在喉罩插入时、气腹开始、气腹后10min以及气腹结束时4个时间点处均明显高于PLMA组患者,差异具有统计学意义(P<0.05)。PLMA组患者在的Et CO2值在喉罩插入时和气腹开始时2个时间点处明显高于I-gel组患者,差异具有统计学意义(P<0.05)。两组患者的阻力、呼吸功、每分钟通气量及气道峰压在4个时间点处均无明显差异,差别不具有统计学意义(P>0.05)。两组患者都未发生喉罩插入失败的案例,并且喉罩插入时间无明显差异,差别不具有统计学意义(P>0.05)。两组患者均有不良反应发生,但不良反应发生率比较无明显差异,差别不具有统计学意义(P>0.05)。结论 PLMA喉罩相较于I-gel喉罩具有较高的密封压力、较大的引流管,能产生足够的机械通气和氧合作用,提示PLMA喉罩比I-gel喉罩更适合应用于腹腔镜胆囊切除手术中。 Objective To compare the influence of third generation of LMA (PLMA) and the I-gel la- ryngeal mask on respiratory mechanics during laparoscopic cholecystectomy. Methods A total of 68 patients for elective laparoscopic cholecystectomy under general anesthesia were randomly divided into PLMA group and I-gel group, who were assigned to take PLMA or I-gel LMA respectively during surgery. Respiratory me- chanics parameters were monitored and compared between two groups. Results As compared with the patients in PLMA group, the dynamic compliance at the time of LMA insertion, pneumoperitoneum, 10minutes after pneumoperitoneum and at the end of pneumoperitoneum in group I-gel were significantly higher than that in PLMA group (P 〈 0.05 ). The EtCO2 at the time of LMA insertion and pneumoperitoneum in PLMA group were significantly higher than that in I-gel group (P 〈 0.05). The resistance, respiratory function, ventilation volume per minute and airway peak pressure at four time points in two groups had no significant difference (P 〉 0.05). There was no laryngeal mask insertion failure case in two groups, and the LMA insertion time in two groups had no significant difference (P 〉 0.05). Both groups had adverse reactions, but there was no significant difference in incidence of adverse reactions between two groups (P 〉 0.05). Conclusion As compared to 1-gel LMA, PLMA obtained higher sealing pressure and the larger drainage tube, which produced sufficient me- chanical ventilation and oxygenation. Therefore, PLMA was a more suitable ventilatory device in laparoscopic surgery than I-lel LMA.
出处 《现代消化及介入诊疗》 2015年第3期216-218,314,共4页 Modern Interventional Diagnosis and Treatment in Gastroenterology
关键词 PLMA喉罩 I-gel喉罩 腹腔镜胆囊切除术 呼吸力学 PLMA I-gel LMA Laparoscopic cholecystectomy Respiratory mechanics
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