喉罩通气与气管插管麻醉对阑尾炎腹腔镜手术患者的影响比较分析

Comparative analysis of the effects of laryngeal mask ventilation and ttracheal intubation anesthesia on patients with appendicitis undergoing laparoscopic surgery

目的探讨喉罩通气与气管插管麻醉对阑尾炎腹腔镜手术患者影响的差异性。方法选取2015年1月至2018年1月本院收治的住院行腹腔镜手术的80例急性阑尾炎患者作为研究对象,采用随机数字法分为A组和B组,每组40例。A组采取喉罩通气全身麻醉,B组采取气管插管麻醉;观察比较两组患者不同时间点心率(HR)、收缩压(SDP)、舒张压(DBP)、血氧饱和度(SPO 2)、气道峰压(Ppeak)、呼气末二氧化碳分压(PETCO 2)及并发症发生情况。结果两组患者T0时HR、SDP、DBP比较,差异均无统计学意义(P>0.05);A组患者T1~T4时HR、SDP、DBP均明显小于B组,差异均有统计学意义(P<0.05)。两组患者各时间点SPO 2、PETCO 2比较,差异均无统计学意义(P>0.05);A组患者T1~T4时Ppeak均明显小于B组,并发症发生率明显低于B组,差异均有统计学意义(P<0.05)。结论对于阑尾炎腹腔镜手术患者,喉罩全身麻醉优于气管插管麻醉,气道反应小,血流动力学更为稳定,安全性更高,值得在临床推广应用。

Objective To investigate the effect of laryngeal mask ventilation and tracheal intubation anesthesia on patients with appendicitis undergoing laparoscopic surgery.Methods Eighty patients with acute appendicitis who underwent laparoscopic surgery in our hospital from January to February 2018 were enrolled in the study.They were randomly divided into group A and group B,with 40 cases in each group.Group A was treated with general anesthesia for laryngeal mask,and group B was treated with tracheal intubation anesthesia.Heart rate(HR),systolic blood pressure(SDP),diastolic blood pressure(DBP),and oxygen saturation were observed at different time points(SPO 2),peak airway pressure(PETCO 2),end-tidal carbon dioxide partial pressure(Ppeak)and complications.Results There was no significant difference in HR,SDP and DBP between group A and group B(P>0.05).The HR,SDP and DBP of group A,T1-T4 were significantly lower than group B(P<0.05).There were no significant differences in SPO 2 and PETCO 2 between group A and group B at each time point(P>0.05).The Ppeak of group A,T1-T4 were significantly lower than group B(P<0.05).The complication rate was 7.50%in group A and 22.50%in group B.The complication rate in group A was significantly lower than that in group B(P<0.05).Conclusion For patients with appendicitis undergoing laparoscopic surgery,general anesthesia with laryngeal mask is superior to endotracheal intubation anesthesia,with less airway response,more stable hemodynamics,and higher safety.It is worthy of clinical application.