喉罩通气在婴幼儿腹腔镜疝高位结扎术中的临床应用

Clinical application of laryngeal mask ventilation in laparoscopic high ligation of hernia in infants

目的探讨喉罩通气在婴幼儿腹腔镜疝高位结扎术中的临床应用效果。方法选取2019年6月至2021年6月宜春市人民医院行腹腔镜疝高位结扎术的60例婴幼儿作为研究对象,按照随机数字表法分为喉罩组和气管导管组,各30例。喉罩组采取喉罩通气全身麻醉,气管导管组采取气管插管全身麻醉。比较两组患儿不同时间点[麻醉诱导前(T_(1))、置入喉罩或插入气管导管时(T_(2))、建立气腹后(T_(3))、拔除喉罩或气管导管时(T_(4))、拔除喉罩或气管导管后3 min(T_(5))]生命体征指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))]的变化情况以及拔除喉罩或气管导管后并发症情况的差异。结果喉罩组T_(2)、T_(3)、T_(4)时刻HR监测结果均低于气管导管组,差异有统计学意义(P<0.05);喉罩组T_(2)、T_(3)、T_(4)、T_(5)时刻MAP监测结果均低于气管导管组,差异有统计学意义(P<0.05);两组患儿T_(2)、T_(3)、T_(4)、T_(5)时刻SpO_(2)监测结果比较,差异无统计学意义(P>0.05);喉罩组拔除喉罩后并发症总发生率低于气管导管组,差异有统计学意义(P<0.05)。结论喉罩通气在婴幼儿腹腔镜疝高位结扎术中的应用效果和安全性均优于气管导管,值得临床推荐。

Objective To explore the clinical effect of laryngeal mask ventilation in high ligation of laparoscopic hernia in infants.Methods A total of 60 infants who underwent laparoscopic high ligation of hernia in Yichun People's Hospital from June 2019 to June 2021 were selected as research objects.According to the random number table,they were divided into laryngeal mask group(30 cases)and tracheal tube group(30 cases).Laryngeal mask group was given general anesthesia with laryngeal mask ventilation,and endotracheal tube group was given general anesthesia with endotracheal tube.The changes of vital signs(heart rate[HR],mean arterial pressure[MAP],blood oxygen saturation[SpO_(2)])and complications after laryngeal mask or tracheal tube removal were compared between the two groups at different time points(before anesthesia induction[T_(1)],when laryngeal mask or tracheal tube was inserted[T_(2)],after pneumoperitoneum was established[T_(3)],when laryngeal mask or tracheal tube was removed[T_(4)],and 3 min after laryngeal mask or tracheal tube was removed[T_(5)]).Results The HR monitoring results of laryngeal mask group at T_(2),T_(3) and T_(4) were lower than those of tracheal tube group,the differences were statistically significant(P<0.05).The MAP monitoring results of laryngeal mask group at T_(2),T_(3),T_(4) and T_(5) were lower than those of tracheal tube group,the differences were statistically significant(P<0.05).There were no significant differences in SpO_(2) monitoring results between the two groups at T_(2),T_(3),T_(4) and T_(5)(P<0.05).The total complication rate of laryngeal mask group after removing laryngeal mask was lower than that of tracheal tube group,the difference was statistically significant(P<0.05).Conclusion Laryngeal mask ventilation in high ligation of laparoscopic hernia in infants is better than tracheal tube in effect and safety,which is worthy of clinical recommendation.