经口咽气道面罩通气全麻用于腹腔镜胆囊切除术20000例临床观察.docVIP

精品论文 参考文献 经口咽气道面罩通气全麻用于腹腔镜胆囊切除术20000例临床观察 张永福 刘远安 吕斌 黄国荣 杜如飞　张俊榕 曲靖市第二人民医院（云南曲靖655000） 【摘 要】 　　目的探讨经口咽气道面罩通气在腹腔镜胆囊切除术全麻中通气支持的可行性有效性和安全性。 　　方法 1.随机对50例面罩组与50例插管组患者在相应时段的血气进行参数比较；2.对两组各100例Co2气腹前后各时段的PaW、SPO2、MAP、HR等参数比较；3.对两组各1000例患者在腹腔镜直视下观察术中胃彭胀情况；4.对两组各100例患者对麻醉药用量、麻醉操作时间、麻醉时间、清醒时间、术后咽喉痛等相关情况进行观察比较。 　　结果面罩通气组与气管插管组在气腹15min后PaW、PETCo2、MAP、HR都明显高于术前，两组相比较气管插管组在气管插管及拔除气管导管操作时MAP、HR的变化显著，均明显高于面罩通气组（P＜0.01）。两组患者术中胃彭胀情况无显著性差异。面罩通气组比气管插管组的麻醉操作时间短、麻醉药用量少，术后清醒快，在手术间停留时间短，术后咽喉痛病例显著减。 　　结论经口咽气道面罩通气技术具有操作简便，成功率高、刺激小，无心血管应激反应，通气效果可靠，麻醉药用量少，术后清醒快等优点，可作为腹腔镜胆囊切除术全麻中通气支持的另一种气道管理方法。 【关键词】经口咽气道面罩无创通气全身麻醉胆囊切除腹腔镜 ［中图分类号］R［文献标识码］A［文章编号］1810－5734(2012)10－49-03 Clinical observation of oropharyngeal airway mask ventilation during general anesthesia in 20000 laparoscopic cholecystectomy cases Department of Anesthesiology Qujing Second Peoples Hospital of Yunnan ProvinceZhang Yongfu Liu Yuanan Lv Bin Huang Guorong Du Rufei Zhang junrong 【Abstract】 Objective To explore the ventilatory support feasibility,effectiveness and safety of oropharyngeal airway mask ventilation for general-anesthetized patients in laparoscopic cholecystectomy. Methods 1 blood gas parameter comparison were made between 50 cases of mask ventilation group and 50 cases of endotracheal intubation group patients in certain period of time.2 Comparison of PaW, SPO2, MAP, HR parameters were made between two groups of 100 patients each before and after Co2 pneumoperitoneum.3 intraoperative gastric distension were observed via laparoscope in two groups of 1000 patients each.4 the dosage of anesthetics, anesthesia operation time, anesthesia time, recovery time, postoperative sore throat and other related conditions were observed and compared between two groups of 100 patients each. Results PETCo2,MAP, PaW, HR were higher 15min after pneumoperitoneum than that before the operation in both mask ventilation and endotracheal intubation group, Significant change of MAP, HR were observed in endotracheal intubation group