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食管引流型喉罩与吸引型喉导管在腹腔镜胆囊切除术的应用

赵茗姝1,高宝柱2   

  1. 1. 天津市第三中心医院麻醉科
    2. 第三中心医院麻醉
  • 收稿日期:2009-12-28 修回日期:2010-09-09 出版日期:2011-01-15 发布日期:2011-01-15
  • 通讯作者: 赵茗姝

Application of Proseal Laryngeal Mask Airway and Laryngeal Tube Suction in Laparoscopic Cholecystectomy

  • Received:2009-12-28 Revised:2010-09-09 Published:2011-01-15 Online:2011-01-15

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摘要： 摘要 目的：比较食管引流型喉罩与吸引型喉导管在腹腔镜胆囊切除术麻醉时的通气效果。 方法：择期行腹腔镜胆囊切除术患者40例，随机分为食管引流型喉罩（PLMA）组与吸引型喉导管(LTS)组，行麻醉中通气，监测记录两组患者入室时、插管前、插管后1min、3min时的MAP、HR、SpO2，并于气腹前（T1）、气腹后15min（T2）、解除气腹后15min（T3）测动脉血pH值、PaCO2及气道压力（Paw）。结果：气腹后15min与气腹前相比，两组患者Paw及PaCO2明显增高（P<0.05）。但两组之间各时点数据的差异无统计学意义（P＞0.05）。结论：将PLMA和LTS应用于腹腔镜气腹手术患者，均能保证术中良好通气和血流动力学稳定，未见与通气相关的并发症，是腹腔镜手术可选用的通气方法。

关键词: 胆囊切除术, 腹腔镜, 喉面罩, 插管法, 气管内, 气腹, 人工, 麻醉

Abstract: Abstract Objective: To compare the effect of the proseal laryngeal mask airway (PLMA)and laryngeal tube suction (LTS) for ventilation in laparoscopic cholecystectomy. Methods: Forty patients undergoing elective laparoscopic cholecystectomy were enrolled in this study. The patients were randomly divided into two groups, PLMA group and LTS group,with 20 cases in each goup. The mean blood pressure (MBP), heart rate (HR), and oxygen saturation of pulse (SpO2) were recorded during operation. pH, PaCO2, Paw were recorded at before pneumoperitoneum , 15 min after pneuoperitoneum setting and 15min after pneuoperitoneum deflation. Results: Compared with before pneumoperitoneum, the PaCO2, Paw of 15 min after pneuoperitoneum setting were significantly increased（P<0.05）. The data of the three time points between two groups had no significantly difference（P＞0.05）. Conclusion: Applicated the PLMA and the LTS in laparoscopic operation, could ensure the stability of ventilation and hemodynamics, was the optimal selection.

Key words: Cholecystectomy, Laparoscopic, Laryngeal Masks, Intubation, Intratracheal, Pneumoperitoneum, Artificial, 麻醉