喉罩通气应用于老年患者腹部手术麻醉对术后肺部并发症的影响

发布时间：2018-01-16 03:20

  本文关键词：喉罩通气应用于老年患者腹部手术麻醉对术后肺部并发症的影响　出处：《上海医学》2015年04期 　论文类型：期刊论文

  更多相关文章： 喉罩 管插管 年患者 后肺部并发症

【摘要】：目的队列分析行腹部手术的老年患者术中喉罩通气与气管插管对术后肺部并发症和患者病死率的影响。方法收集上海东方肝胆外科医院2010年1月—2013年7月间年龄65岁、于全身麻醉下择期行腹部手术的患者的临床资料,将术中使用喉罩通气的患者列入喉罩组,使用气管插管通气的患者列入气管插管组,比较两组间患者的一般情况。收集并比较术后入ICU且需行机械通气患者的临床资料,以及术后入ICU且需行机械通气患者的肺部并发症情况。结果应用医院信息系统(HIS)共搜索到符合本研究纳入标准和排除标准的患者2 629例,其中喉罩组1 297例、气管插管组1 332例,两组间患者的性别构成、年龄、体重、术前血红蛋白(Hb)水平、美国麻醉医师协会(ASA)分级构成、术中出血量,以及术中输血和输液量的差异均无统计学意义(P值均0.05)。术后需入ICU且需行机械通气的患者109例,喉罩组58例、气管插管组51例,两组间患者的性别构成、年龄、体重、平均住院天数、ICU住院天数、因肺部并发症和其他原因入ICU的构成比、ICU病死率,以及术后最高急性生理与慢性健康评分(APACHEⅡ评分)的差异均无统计学意义(P值均0.05),喉罩组术后最高白细胞计数显著高于气管插管组(P0.05)。喉罩组术后肺不张和肺栓塞发生率均显著低于气管插管组(P值均0.05),两组间肺部感染、急性呼吸窘迫综合征(ARDS)和(或)急性肺损伤(ALI)、胸腔积液发生率的差异均无统计学意义(P值均0.05)。结论与气管插管通气比较,喉罩通气并不能减少老年患者腹部手术后肺部并发症和死亡的发生。
[Abstract]:Objective to analyze the effects of laryngeal mask ventilation and tracheal intubation on postoperative pulmonary complications and mortality in elderly patients undergoing abdominal surgery. Methods from January 2010 to January 2010, Shanghai Oriental Hepatobiliary surgery Hospital. The age was 65 years between July and 3 years. The clinical data of patients undergoing elective abdominal surgery under general anesthesia were divided into laryngeal mask group and tracheal intubation group. To collect and compare the clinical data of patients who entered ICU and needed mechanical ventilation after operation. Results 2629 patients who met the criteria of inclusion and exclusion of this study were found by hospital information system (HIS). There were 1 297 cases in laryngeal mask group and 1 332 cases in tracheal intubation group. The American Association of Anesthesiologists (ASA) was classified as the composition of the intraoperative bleeding volume. There was no significant difference in blood transfusion and infusion volume during operation (P < 0.05). There were 109 patients who needed ICU and needed mechanical ventilation after operation, 58 patients in laryngeal mask group and 51 patients in tracheal intubation group. The sex composition, age, weight, average length of stay in ICU were higher than those in ICU because of pulmonary complications and other reasons. There was no significant difference between the highest acute physiological and chronic health score and Apache 鈪，

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