喉罩通气在妇科腔镜手术的临床应用研究

发布时间：2018-04-10 04:09

本文选题：ProSeal喉罩　切入点：气管插管　出处：《石河子大学》2014年硕士论文

【摘要】：目的：比较妇科腹腔镜手术应用第三代喉罩(ProSeal laryngeal mask airway，PLMA)与气管插管全身麻醉时气道管理的效果和安全性。方法：选择美国麻醉学会Ⅰ-Ⅱ级行妇科腹腔镜全子宫切除术手术患者40例（ASAI-Ⅱ级），随机分为两组。P组使用喉罩通气下静脉复合全麻（20例），T组为气管插管通气下静脉复合全麻（20例），监测记录插管／喉罩前后HR、MAP变化，二氧化碳气腹前后的血气分析变化；分别于入室后（T0）、气腹前（T1）、气腹30min（T2）、气腹60min(T3)、气腹后20min(T4)抽取桡动脉血行血气分析，并记录同一时刻PetCO2值。比较两组患者在不同时点的PetCO2值与动脉血二氧化碳分压（arterialpartialpressure of carbonioxide，PaCO2）值以及术中、术后发生各种并发症的例数。结果：P组置入喉罩前后HR、MAP无明显变化，，而T组插管后HR、MAP显著高于插管前（P0.01)；气腹后P、T组的PaCO2均显著高于气腹前（P0.01)；PetCO2值及PaCO2值在T2和T4时间段的相关性最差；T组咽喉并发症的发生显著高于P组（P0.05)。结论：妇科腹腔镜手术中使用第三代喉罩与气管插管通气效果一致，具有安全性好、血流动力学平稳、并发症少的优点。
[Abstract]:Objective: to compare the efficacy and safety of the third generation laryngeal mask proseal laryngeal mask airway anesthesia in gynecological laparoscopic surgery.Methods: 40 patients undergoing gynecological laparoscopic total hysterectomy were randomly divided into two groups. Group P was treated with laryngeal mask ventilation combined with general anesthesia and 20 cases were treated with laryngeal mask ventilation combined with general anesthesia under endotracheal intubation.The changes of HRMAP before and after intubation / larynx mask were monitored in 20 patients with intravenous combined general anesthesia.The changes of blood gas were analyzed before and after pneumoperitoneum, including T _ 0, T _ (1), T _ (2) T _ (2), T _ (3) at 60 min after pneumoperitoneum and T _ (4) at 20 min after pneumoperitoneum), and the PetCO2 values at the same time were recorded.The values of PetCO2 and arterial partial pressure of carbon dioxide of carbonioxide-Paco _ 2 were compared between the two groups at different time points, and the number of complications occurred during and after operation.Results there was no significant change in HRMAP before and after placement of laryngeal mask in group 1: PHowever, after intubation, HRMAP in group T was significantly higher than that before intubation (P 0.01), PaCO2 in group T was significantly higher than that in group P 0.01 and PaCO2 in T 2 and T 4. The incidence of larynx complications in group T was significantly higher than that in group P (P 0.05).Conclusion: the third generation laryngeal mask is the same as tracheal intubation in gynecological laparoscopic surgery, which has the advantages of good safety, stable hemodynamics and less complications.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

【参考文献】