中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (3): 269–272.doi: 10.12007/j.issn.0258-4646.2016.03.019

• 论著 • 上一篇    下一篇

SLIPA 喉罩在高原气道高反应性患者全麻苏醒期的应用研究

赵永忠,马树勇,宋文学,龚小红,吴佳璇   

  1. 甘肃省酒泉市人民医院麻醉科,甘肃酒泉735000
  • 收稿日期:2015-05-04 出版日期:2016-02-29 发布日期:2016-02-24
  • 作者简介:赵永忠(1973 -),男,副主任医师,本科.

Application of SLIPA Laryngeal Mask Airway in Plateau Airway Hyper-responsiveness in Patients during Anesthesia Recovery Period

ZHAO Yong-zhong,MA Shu-yong,SONG Wen-xue,GONG Xiao-hong,WU Jia-xuan   

  1. Department of Anesthesiology,The People’s Hospital of Jiuquan,Jiuquan 735000,China
  • Received:2015-05-04 Online:2016-02-29 Published:2016-02-24

摘要: 目的 研究高原气道高反应性患者全麻苏醒期深麻醉下拔除气管导管-SLIPA 喉罩替代通气对气道及心血管反应的影响。方法 收集 2014 年 1 月至 2014 年 11 月 ASA 分级Ⅱ或Ⅲ级,经肺功能检查有气道高反应性的择期手术患者 60 例,将患者随机分为保留气管导管通气组(T 组)和深麻醉下拔除气管导管-SLIPA 喉罩替代组(L 组),每组 30 例。比较 2 组麻醉诱导前、拔除气管导管或喉罩前吸痰时、拔除气管导管或喉罩即刻、拔除气管导管或喉罩 1 min、3 min 和 5 min 时的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2)和呼吸末二氧化碳分压(PaCO2)的变化;比较患者从自主呼吸恢复至拔除气管插管或喉罩后 5min 内的呛咳、喘鸣、憋气、气道压升高、不能耐管等气道反应的情况。结果 T 组患者清醒拔除气管导管前后各时点 MAP、HR较术前明显升高(P < 0.05),L 组患者清醒拔除喉罩后上述指标变化差异无统计学意义(P > 0.05),患者深麻醉下拔除气管导管-SLIPA 喉罩替代通气过程 MAP、HR 无明显变化(P > 0.05)。L 组中重度呛咳、喘鸣、憋气、气道压升高、不能耐管发生率低于T 组(P < 0.05)。结论 术毕深麻醉下拔除气管导管-SLIPA 喉罩替代通气能降低气道高反应性患者气道应激反应、维持血流动力学稳定,提高全身麻醉术后苏醒质量。

关键词: 气道高反应性, 苏醒期, 气管导管, 喉罩

Abstract: Objective To study the effect of tracheal extubation combined SLIPA laryngeal mask airway ventilation during recovery from deep anesthesia on airway and cardiovascular responses of hyperresponsiveness patients. Methods Sixty patients,ASA grade II-III by pulmonary function tests,diagnosed of airway hyperresponsiveness between 2014 January and 2014 November were recruited for the study,and randomly divided into tracheal catheter ventilation group(group T) and the removal of - SLIPA under deep anesthesia laryngeal mask instead of group(group L),with 30 patients in each group. The mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SPO2) and end expiratory carbon dioxide into two pressure(PaCO2)changes of two groups before induction of anesthesia,removal of the endotracheal tube or laryngeal mask airway Sputum suction time,before removal of the endotracheal tube or laryngeal mask,mean arterial immediate removal of the endotracheal tube or laryngeal mask 1 min,3 min and 5 min were compared;in addition,coughing,wheezing,shortness of breath,airway pressure,and airway resistance situations from the spontaneous breathing recovery to endotracheal intubation or laryngeal mask after 5 min were analyzed. Results MAP,HR was significantly higher in patients of group T at each time point than that before operation(P < 0.05). There was no statistical significance of patients awake of removing laryngeal mask airway changes(P > 0.05). There was no significant change of MAP,HR in patients under deep anesthesia extubation - SLI- PA laryngeal mask instead of ventilation process(P > 0.05). The severe cough,wheezing,shortness of breath,airway pressure,the failure incidence is lower in group L than that of group T(P < 0.05). Conclusion Surgery under deep anesthesia extubation - SLIPA laryngeal mask instead of Ventilation can reduce airway hyperresponsiveness and airway stress response,maintain the stability of hemodynamics,improve the quality of recovery after general anesthesia.

Key words: airway hyperresponsiveness, recovery period, endotracheal tube, mask

中图分类号: 

  • R614.2
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