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时间:2020-05-02
《喉罩通气在鼻内窥镜手术麻醉中的应用.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、中国预防医学杂志2O12年12月第13卷第12期ChinPreyMed,December2012,Vo1.13No.12.933.·论著·喉罩通气在鼻内窥镜手术麻醉中的应用姚东旭,陈继彬1.首都医科大学宣武医院麻醉科,北京100053;2.中华预防医学会摘要:目的比较一次性喉罩与气管插管用于鼻内窥镜手术麻醉中对血流动力学及呼吸动力学的影响。方法将拟在全身麻醉下择期行鼻内窥镜手术的4O例患者随机分为喉罩组(LMA)和气管插管组(TT),每组各2O例。全麻诱导后行LMA或TT置人。分别记录两组患者在麻醉诱导前、诱导后、LMA/TT置人后即刻及LMA/TT拔除后即刻的平均动脉压(MAP)、心率
2、(HR)和血氧饱和度(SpO)数值;同时在麻醉诱导后5、15、30min记录吸气峰值(PIP)、吸气平台压(P山)、平均气道压(P⋯)、吸气峰流速(FI⋯)、呼气峰流速(F一)和动脉血气等呼吸动力学指标;并对置入IMA和TT的一次成功率和不良事件发生率进行比较。结果置人后及拔除LMA/TT时LMA组的MAP显著低于TT组(分别为6.45、2.76,Pd0.05),HR也显著低于TT组(£分别为4.5O,2.39,P<0.05);同时LMA组在各测定时点的PIP、Pi⋯⋯P和Fz⋯明显低于TT组(P均d0.05)。LMA组的呛咳、咽痛和肌肉酸痛等不良事件的发生率也明显低于TT组(P3、5)。结论在鼻内窥镜手术的麻醉中,一次性喉罩在血流动力学和呼吸动力学方面的安全性优于气管内插管。关键词:一次性喉罩;鼻内窥镜手术;血流动力学;呼吸动力学中图分类号:R782.05文献标识码:A文章编号:1009—6639(2012)12-0933—03ApplicationofdisposablelaryngealmaskairwayinfunctionalendoscopicsinussurgeryYAoDong—xu.CHENJi—binDepartmentofAnesthesi0logyofXuanwuHospital,CapitalMedicalUniversity,Beijin4、g100053,ChinaCorreso"dngauthor:CHENJi—bin,E-mail:garychenjb@163.cornAbstract:ObjectiveToassesstheciinicalperformanceofdisposablelaryngealmaskairway(LMA)bycom~paringtheeffectonhemodynamicsandrespiratorymechanicsofLMAwithendotrachealintubation(ETT)infunctionalendoscopicsinussurgery.Methods40patient5、sundergoingfunctionalendoscopicsinussurgerieswereenrolledinthestudy.TheywereevenlyandrandomlyassignedintoLMAgroupandETTgroupwhowereeitherappliedwithLMAorETTafterinductionofgeneralanesthesia;Meanarterialpressure(MAP)。heartrate(HR)andoxygensaturation(SpO2)wererecordedbeforeandaftertheinductionofane6、sthesia,aswellasrightaftertheinsertingandremovalofETTorLMA.Parametersforrespiratorymechanicsincludingpeakinspiratorypressure(PIP),plateauairwaypressure(P。1m),meanairwaypressure(P⋯),positiveendexpiratorypressure(PEEP),peakinspiratoryflow(FI⋯),peakexpiratoryflow(FE⋯)werealsore—cordedat5,15and30minu7、tesafterinduction.Meanwhile,thefirst—timeinsertionsuccessrateandcomplica—tionsupto24hoursafterextubationforLMAandETTwerecomparedaswel1.ResultsTheMAPandHRateachrecordedpointsinLMAgroupweresignificantlylowerthanthoseinET
3、5)。结论在鼻内窥镜手术的麻醉中,一次性喉罩在血流动力学和呼吸动力学方面的安全性优于气管内插管。关键词:一次性喉罩;鼻内窥镜手术;血流动力学;呼吸动力学中图分类号:R782.05文献标识码:A文章编号:1009—6639(2012)12-0933—03ApplicationofdisposablelaryngealmaskairwayinfunctionalendoscopicsinussurgeryYAoDong—xu.CHENJi—binDepartmentofAnesthesi0logyofXuanwuHospital,CapitalMedicalUniversity,Beijin
4、g100053,ChinaCorreso"dngauthor:CHENJi—bin,E-mail:garychenjb@163.cornAbstract:ObjectiveToassesstheciinicalperformanceofdisposablelaryngealmaskairway(LMA)bycom~paringtheeffectonhemodynamicsandrespiratorymechanicsofLMAwithendotrachealintubation(ETT)infunctionalendoscopicsinussurgery.Methods40patient
5、sundergoingfunctionalendoscopicsinussurgerieswereenrolledinthestudy.TheywereevenlyandrandomlyassignedintoLMAgroupandETTgroupwhowereeitherappliedwithLMAorETTafterinductionofgeneralanesthesia;Meanarterialpressure(MAP)。heartrate(HR)andoxygensaturation(SpO2)wererecordedbeforeandaftertheinductionofane
6、sthesia,aswellasrightaftertheinsertingandremovalofETTorLMA.Parametersforrespiratorymechanicsincludingpeakinspiratorypressure(PIP),plateauairwaypressure(P。1m),meanairwaypressure(P⋯),positiveendexpiratorypressure(PEEP),peakinspiratoryflow(FI⋯),peakexpiratoryflow(FE⋯)werealsore—cordedat5,15and30minu
7、tesafterinduction.Meanwhile,thefirst—timeinsertionsuccessrateandcomplica—tionsupto24hoursafterextubationforLMAandETTwerecomparedaswel1.ResultsTheMAPandHRateachrecordedpointsinLMAgroupweresignificantlylowerthanthoseinET
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