SLIPA喉罩用于全身麻醉下小儿保留自主呼吸的可行性和安全性

Feasibility and Safety of SLIPA Laryngeal Mask for Pediatric Retaining Spontaneous Respiration under General Anesthesia

目的:探讨SLIPA喉罩在全身麻醉下小儿术中保留自主呼吸的可行性和安全性。方法:将本院在SLIPA喉罩全身麻醉下手术治疗的患儿按照随机数字飙风分为保留自主呼吸组和机械通气组,记录喉罩置入即刻、置入后10、30、60 min的心率、MAP、PaO_2、PaCO_2、PETCO_2、pH值、肺泡-动脉氧分压差、呼吸指数等指标变化。结果:保留自主呼吸组患儿在各时间点心率、MAP、PaO_2比较,差异均无统计学意义(P>0.05),置入后10、30、60 min PaCO_2、P_(ET)CO_2均较喉罩置入即刻明显升高,pH值明显降低,差异均有统计学意义(P<0.01),但置入后60 min PaCO_2、P_(ET)CO_2呈降低趋势,p H值呈上升趋势。机械通气组患儿在各时间点心率、MAP、PaO_2、PaCO_2、P_(ET)CO_2、p H值比较,差异均无统计学意义(P>0.05)。两组患儿各时间点心率、MAP、PaO__2比较,差异均无统计学意义(P>0.05),保留自主呼吸组患儿置入后10、30、60 min PaCO_2、P_(ET)CO__2明显高于机械通气组,pH值明显低于机械通气组,差异均有统计学意义(P<0.01)。两组患儿组内及组间各时间点P(A-a)DO_2及RI比较,差异均无统计学意义(P>0.05)。结论:SLIPA喉罩用于全身麻醉下小儿保留自主呼吸是安全可行的,但全麻中要对PaCO_2、P_(ET)CO_2及pH值进行严密监测,并对CO_2蓄积所致高碳酸血症引起足够的重视。

Ojeive： o inveige he feiiliy nd fey of LIP lyngel mk fo pedii eining ponneou epiion unde he genel nehei.Mehod： he hilden who wee opeed unde he LIP lyngel mk genel nehei of ou hopil wee ndomly divided ino eining ponneou epiion goup nd mehnil venilion goup, eoded he hnge of he e, MP, PO2, PO2, PE02, pH, lveol-eil oxygen enion diffeene, epioy index in lyngel mk ineion inn, 10, 30, 60 min fe ineion.eul： he diffeene of he e, MP, P02 of eining ponneou epiion goup hilden diffeen ime poin hd no iil ignifine （P〉0.05）, PO2, PO2 vlue 10, 30, 60 min fe ineion wee highe hn he lyngel mk ineion inn, nd pH vlue w deeed oviouly, he diffeene hd iil ignifine （P〈0.01）, u P02, PEO2 vlue 60 min fe ineion howed deeed end, pH vlue howed ied end.he diffeene of he e, MP, PO2, PO2, PE02, pH vlue of mehnil venilion goup hilden diffeen ime poin hd no iil ~ignifine （ P〉0.05 ） .He e, MP, PO2 vlue diffeen ime poin of wo goup hd no iil ignifine （ P〉0.05 ）, PO2, PEO2 vlue 10, 30, 60 min fe ineion of eining ponneou epiion goup hilden wee ignifinly highe hn hoe of he mehnil venilion goup, pH vlue w lowe hn h of he mehnil venilion goup, he diffeene hd iil ignifine （ P〈0.01 ） . P （ - ） DO2 nd I vlue diffeen ime poin wihin he goup nd eween goup oh hd no iil ignifine （ P〉0.05 ） .onluion： LIP lyngel mk fo pedii eining ponneou epiion unde genel nehei i fe nd feile, u PO2, PEO2 nd pH mu e efully monioed in he genel nehei, nd 02 umulion ue y hypepni mu ue enough enion.