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

发布时间：2018-01-03 06:31

本文关键词：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　出处：《中国医学创新》2016年35期 　论文类型：期刊论文

【摘要】：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(P0.05),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(P0.01),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(P0.05)。两组患儿各时间点心率、MAP、PaO__2比较,差异均无统计学意义(P0.05),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(P0.01)。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(P0.05)。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。
[Abstract]:Objective: to investigate the feasibility and safety of SLIPA larynx mask in preserving spontaneous respiration in children under general anesthesia. Children undergoing general anesthesia with SLIPA laryngeal mask in our hospital were divided into two groups according to the random number of wind winds: the group of retained spontaneous respiration and the group of mechanical ventilation. The heart rate was recorded immediately after the laryngeal mask placement and 10 ~ 30 ~ 60 min after placement. The heart rate was MAPPao, and Paco _ 2P _ (2) P _ (CO _ (2)) / PETCO _ (2), and the difference of oxygen pressure difference between the alveolar artery and the artery. Results: there was no significant difference in heart rate and MAPP Pao _ 2 between the two groups at each time point, but there was no significant difference between the two groups (P 0.05). Compared with the immediate laryngeal mask placement, the pH value of 60 min Paco _ 2 in all cases was significantly lower than that in the laryngeal mask (P < 0.01). However, after 60 min Paco _ 2P _ (2) / P _ (+) / P _ (COC) _ 2, there was a decreasing trend and a rising trend in the value of ethylcholine (H). In the mechanical ventilation group, the heart rate was increased at each time point (P < 0.05). There was no significant difference in the value of Paco _ 2P _ 2C _ 2C _ 2P _ H between the two groups. The two groups were compared with each other at each time point. There was no significant difference between the two groups (P 0.05). The number of Paco _ 2P _ T _ (2) in the group of retained spontaneous respiration was significantly higher than that in the group of mechanical ventilation (10 ~ 30 ~ 60 min after placement). The pH value was significantly lower than that in the mechanical ventilation group (P 0.01). Conclusion it is safe and feasible for children to retain their own breathing under general anesthesia, but PaCO_2 should be used in general anesthesia. The pH value and the pH value were closely monitored, and sufficient attention was paid to the hypercapnia caused by the accumulation of CO_2.
【作者单位】：广东省东莞康华医院;
【基金】：广东省东莞市科技局立项项目(2014105101031)
【分类号】：R726.1
【正文快照】： SLIPA喉罩作为新型喉上通气装置,凭借其操作简单易行,不易移位,刺激小等优点,已在小儿全身麻醉机械通气中广泛应用[1],但在小儿保留自主呼吸的全麻中应用较少。随着全麻机械通气引起的术后呼吸抑制、肺损伤被逐渐发现并认识,已有研究显示,对手术肌松条件要求不高,手术时间较短

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