喉罩通气在甲状腺手术全身麻醉中应用.docVIP

喉罩通气在甲状腺手术全身麻醉中应用【摘要】 目的 观察甲状腺手术中应用喉罩通气行全身麻醉对血流动力学的影响。方法 50例甲状腺手术的择期手术患者，随机分成气管插管组（T组）和喉罩置入组（L组），每组25例，气管插管用喉镜明视插入法，喉罩置入按顺行盲探置入口底。记录麻醉诱导前（T0）、诱导后（T1）气管插管后1 min（T2）、3 min（T3）、拔除气管导管或喉罩后1 min（T4）各时间点的SBP、DBP、HR值，术后3 d随访患者咽痛、声音嘶哑的发生率。结果 T组在插管后1 min（T2）、3 min（T3）、拔管后1 min（T4）SBP、DBP、HR较诱导前明显升高（P＜0.05），而L组在T2、T3、T4点SBP、DBP、HR与T0相比，无明显差异（P0.05）；组间比较，T组在T2、T3、T4点的SBP、DBP、HR明显高于L组（P＜0.05）。术后L组咽痛、声音嘶哑发生例数少于T组（P＜0.05）。结论 喉罩通气全身麻醉对血流动力学影响小，不良反应小，适合于甲状腺手术全麻的要求。 【关键词】 喉罩通气；全身麻醉；甲状腺切除术 Application of Laryngeal Mask-airway in General Anesthesia for Thyroidectomy Patients CHEN Xiao-yan,HAN Wei.Department of Anesthesiology,People’s Hospital of JiXi,Heilongjiang 158100，China 【Abstract】 Objective To study the effect of laryngeal mask airway (LMA) for hemodynamic changes in general anesthesia for thyroidectomy patients. Methods 50 patients who underment thyroidectomy were randomly divided into 2 groups with 25 cases each,including group T with tracheal intubation by laryoscopy and group L with blind antegrade LMA insertion to mouth floor .The value of SBP、DBP and HR were measured at the time before trcheal intubation or LMA insertion (T0), and after intubation or LMA placing 1 minutes(T2),3 minutes(T3),after extubate intubation or LMA 1 minutes(T4) . And morbidity rate of side-injury such as pharyngody and hoarseness were recorded during 3 days after operation. Results There was no obvious hemodynamic change at T2~T4 amony the group L(P0.05),while the SBP、DBP and HR at T2~T4 were significantly higher than those of T0 in group T(P＜0.05).Comparing with group L,the value of SBP、DBP and HR were remarkable higher in group T at T2~T4.The morbidity rate of pharyngodynia and hoarseness after operation was obviously higher in group T than that of group L (P＜0.05).Conclusion LMA was suitable for thyroidectomy operation with less hemodynamic changes ,higher safety and less side-effect. 【Key words】 Laryngeal mask;General anesthesia ; Thyroidectomy 喉罩是集面罩和气管内插管优点于一体的维持气道的新型麻醉器具,喉罩