加强型喉罩用于小儿扁桃体腺样体切除术的效果及安全性

发布时间：2018-12-11 00:38

【摘要】：目的探讨加强型喉罩用于小儿扁桃体腺样体切除术的效果及安全性。方法选择择期行扁桃体腺样体切除术的住院患儿60例,年龄4~12岁。采用随机数字表法均分为喉罩组(L组)和气管插管组(T组)。观察并记录诱导前5min(T0)、插入喉罩或气管插管时(T1)、置开口器时(T2)、手术开始时(T3)及拔除喉罩或气管插管前(T4)的HR、MAP、SpO2;记录T1~T4时的VT、PETCO2及T1~T3时的气道峰压(Ppeak);记录喉罩或气管插管首次插入成功率和总成功率、手术时间、苏醒时间、丙泊酚和瑞芬太尼的用量,并记录术中及术后呛咳、喉痉挛、反流误吸及苏醒期躁动等不良反应的发生情况。结果 L组患儿苏醒时间明显短于T组(P0.05);与T组比较,T1、T2、T4时L组HR明显减慢,T1时L组MAP明显降低(P0.05或P0.01);与T0时比较,T1、T2、T4时T组HR明显增快(P0.05);而两组SpO2、VT、PETCO2、Ppeak比较差异均无统计学意义;与T组比较,L组术后呛咳、苏醒期躁动发生率明显降低(P0.01或P0.05),而两组喉罩或气管插管首次成功率和总成功率、丙泊酚用量、瑞芬太尼用量、喉痉挛及反流误吸的发生率差异均无统计学意义。结论加强型喉罩用于小儿扁桃体腺样体切除术中,可保持气道通畅,获得良好的通气效果,血流动力学平稳,苏醒时间短,不良反应少。因此其用于该类手术中安全有效,值得在临床上推广应用。
[Abstract]:Objective to evaluate the efficacy and safety of enhanced laryngeal mask for tonsillectomy in children. Methods A total of 60 hospitalized children, aged 4 to 12 years, underwent tonsillectomy. All patients were randomly divided into laryngeal mask group (group L) and tracheal intubation group (group T). Observe and record HR,MAP,SpO2; of 5min (T0) before induction, insertion of laryngeal mask or tracheal intubation (T1), insertion of opening device (T2), beginning of operation (T3), and removal of laryngeal mask or tracheal intubation (T4) Record VT,PETCO2 at T1~T4 and (Ppeak); at T1~T3 The first and total success rate of laryngeal mask or tracheal intubation, operation time, recovery time, dosage of propofol and remifentanil were recorded. Adverse reactions such as reflux missuction and restlessness during recovery. Results the recovery time of children in group L was significantly shorter than that in group T (P0.05), HR in group L was significantly slower than that in group T _ 1 and MAP in group L was significantly decreased at T _ 1 and T _ 2 / T _ 4 (P0.05 or P0.01). Compared with T0, the HR of T1T2T4 group increased significantly (P0.05), but there was no significant difference in SpO2,VT,PETCO2,Ppeak between the two groups. Compared with group T, the incidence of coughing and restlessness in group L was significantly lower than that in group T (P0.01 or P0.05), while the first and total success rates of laryngeal mask or tracheal intubation, dosage of propofol and remifentanil were significantly lower in group L than in group T (P0.01 or P0.05). There was no significant difference in the incidence of laryngeal spasm and reflux aspiration. Conclusion the improved laryngeal mask for adenoidectomy of tonsil in children can keep the airway unobstructed, obtain good ventilation effect, stable hemodynamics, short recovery time and less adverse reactions. Therefore, it is safe and effective in this kind of surgery, and it is worth popularizing in clinic.
【作者单位】：山东大学齐鲁儿童医院麻醉科;
【分类号】：R766.9

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