静脉全身麻醉气道管理方式在输尿管结石输尿管钬激光手术患者中的应用价值

Application value of intravenous general anesthesia airway management in patients undergoing ureteral holmium laser surgery for ureteral calculi

目的探讨静脉全身麻醉气道管理方式在输尿管结石输尿管钬激光手术患者中的应用价值。方法选取2020年10月至2021年10月于萍乡市第三人民医院行输尿管结石输尿管钬激光手术的60例患者作为研究对象,按照随机数字表法分为气管插管(TC)组与喉罩(LM)组,每组30例。两组均行全身静脉麻醉,TC组行气管插管气道管理方式,LM组行喉罩植入气道管理方式,比较两组不同时间血流动力学指标、手术室滞留时间、术后康复时间、生理舒适度、结石清除率、治疗优良率及不良反应发生率。结果T_(1)时,两组平均动脉压(MAP)、血氧饱和度(SpO_(2))均低于T_(0)时,心率(HR)慢于T_(0)时(P<0.05);T_(2)时,两组MAP、SpO_(2)均高于T_(1)时,HR均快于T_(1)时,且TC组MAP、SpO_(2)均低于T_(0)时,HR慢于T_(0)时,差异有统计学意义(P<0.05);T_(2)时,LM组MAP低于T_(0)时(P<0.05),而HR、SpO_(2)与T_(0)时比较差异无统计学意义。T_(1)、T_(2)时,LM组MAP、SpO_(2)均高于TC组,HR快于TC组,差异有统计学意义(P<0.05)。LM组手术室滞留时间、术后康复时间均短于TC组,差异有统计学意义(P<0.05)。LM组生理舒适度评分高于TC组,差异有统计学意义(P<0.05);两组结石清除率、治疗优良率比较差异无统计学意义。LM组不良反应发生率明显低于TC组,差异有统计学意义(P<0.05)。结论与气道插管气道管理方式相比,对输尿管结石输尿管钬激光手术患者应用喉罩植入气道管理方式,对患者血流动力学指标的影响更小,且可缩短手术室滞留时间、术后康复时间,并降低不良反应发生率。

Objective To explore the application value of intravenous general anesthesia airway management in patients undergoing ureteral holmium laser surgery for ureteral calculi.Methods 60 patients with ureteral calculi undergoing ureteral holmium laser surgery admitted to the Third People's Hospital of Pingxiang City from October 2020 to October 2021 were selected as the study subjects,and they were divided into the tracheal intubation(TC)group and the laryngeal mask(LM)group according to the random number table method,with 30 cases in each group.Both groups received general intravenous anesthesia,the TC group received tracheal intubation airway management,the LM group received laryngeal mask implantation airway management,the hemodynamic indexes at different times,operating room retention time,postoperative rehabilitation time,physiological comfort,stone clearance rate,excellent and good treatment rate and incidence of adverse reactions were compared between the two groups.Results At T_(1),the mean arterial pressure(MAP),pulse oxygen saturation(SpO_(2))were lower than T_(0),heart rate(HR)was slower than T_(0)(P<0.05);at T_(2),MAP and SpO_(2) were higher than T_(1),HR was faster than T_(1),and MAP and SpO_(2) in the TC group were lower than those at T_(0),HR was slower than that at T_(0),the differences were statistically significant(P<0.05);at T_(2),MAP was lower than that at T_(0)in the LM group(P<0.05),but there was no significant difference in HR,SpO_(2) between T_(2)and T_(0).At T_(1)and T_(2),MAP and SpO_(2) in the LM group were higher than that in the TC group,and HR was faster than that in the TC group,the differences were statistically significant(P<0.05).The operating room retention time and postoperative rehabilitation time in the LM group were shorter than those in the TC group,and the differences were statistically significant(P<0.05).The physiological comfort scores in the LM group was higher than that in the TC group,and the difference was statistically significant(P<0.05);there was no significant difference in stone clearance rate and excellent and good treatment rate between the two groups.The incidence of adverse reactions in the LM group was significantly lower than that in the TC group,and the differences were statistically significant(P<0.05).Conclusion Compared with the received tracheal intubation airway management,the application of laryngeal mask implantation airway management for ureteral holmium laser surgery patients with ureteral calculi has less impact on the hemodynamic indexes of patients,and can shorten the operating room retention time,postoperative recovery time,and reduce the incidence of adverse reactions.