I-gel喉罩在合并颈椎脱位的小儿急诊外伤手术中的应用

发布时间：2018-12-23 11:05

【摘要】：目的研究I-gel喉罩在合并颈椎脱位的小儿急诊外伤手术麻醉中的临床应用价值。方法 40例接受急诊手术治疗的颈椎脱位患儿,随机分为研究组和对照组,各20例。研究组患儿采用I-gel喉罩,对照组患儿采用普通喉罩。均行静脉吸入全身麻醉,分别将麻醉诱导前(T0)、诱导后(T1),置入喉罩时(T2)、3 min(T3)、10 min(T4),手术结束拔除喉罩前(T5)、拔除时(T6)以及拔除3 min(T7),置入喉罩5 min(T8)、20 min(T9)以及手术结束时,依次记录为时间T0~T10。记录T0~T7时段患儿的心率,T8~T10时段患儿的血氧饱和度、呼气末端二氧化碳和呼吸峰压。记录患儿喉罩一次成功置入的次数和术后24 h内患儿出现的并发症情况。并进行比较。结果与T0时段比较,两组患儿T1~T7时段心率均较高,差异具有统计学意义(P0.05);两组患儿T0~T7时段心率比较差异无统计学意义(P0.05)。两组患儿T8~T10时段血氧饱和度、呼气末端二氧化碳和呼吸峰压比较差异均无统计学意义(P0.05)。研究组患儿置入喉罩时间为(10.2±2.8)s,短于对照组的(38.0±5.7)s,差异具有统计学意义(P0.05);研究组患儿一次置入喉罩成功率为100.0%,高于对照组的80.0%,差异具有统计学意义(P0.05)。术后24 h内,研究组患儿喉罩拔除时表面沾血及患儿出现咽部不适发生率均低于对照组,差异具有统计学意义(P0.05)。结论 I-gel喉罩在小儿颈椎脱位合并外伤手术过程中,对于患儿通气指标和血液动力学的影响与普通喉罩类似,但I-gel喉罩置入时间更短,一次置入成功率更高,术后并发症较少,可有效减轻患儿痛苦。
[Abstract]:Objective to study the clinical application value of I-gel laryngeal mask in emergency trauma surgery for children with cervical dislocation. Methods 40 children with cervical dislocation were randomly divided into study group and control group. I-gel larynx mask was used in study group and common larynx mask was used in control group. After anesthesia induction (T 0), after induction (T 1), 3 min (T 3), 10 min (T 4), 3 min (T 3), 10 min (T 4). At the time of extubation (T6) and extubation 3 min (T7), 5 min (T8), 20 min (T9) and at the end of operation, the time was recorded as T0 T10. Heart rate, oxygen saturation, end expiratory carbon dioxide and peak respiratory pressure were recorded during T0~T7 and T8~T10. The number of successful laryngeal mask implantation and complications within 24 hours after operation were recorded. And the comparison was made. Results compared with the T0 period, the heart rate of the two groups was higher in the T1~T7 period, the difference was statistically significant (P0.05), and there was no significant difference in the heart rate between the two groups in the T0~T7 period (P0.05). There was no significant difference in oxygen saturation, end expiratory carbon dioxide and peak respiratory pressure between the two groups during T8~T10 (P0.05). The time of laryngeal mask placement in the study group was (10.2 卤2.8) s, shorter than that in the control group (38.0 卤5.7) s, the difference was statistically significant (P0.05). The success rate of laryngeal mask implantation in the study group was 100.0, which was higher than that in the control group (80.0), the difference was statistically significant (P0.05). Within 24 hours after operation, the incidence of blood on the surface and pharynx discomfort in the study group was lower than that in the control group (P0.05). Conclusion the effect of I-gel laryngeal mask on ventilation index and hemodynamics in children with cervical dislocation combined with trauma is similar to that of common larynx mask, but the time of I-gel laryngeal mask implantation is shorter, and the success rate of single laryngeal mask implantation is higher. Postoperative complications are less, can effectively alleviate the pain of children.
【作者单位】：苏州大学附属儿童医院;
【分类号】：R726.1

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