老年麻醉患者应用喉罩机械通气的观察.docVIP

精品论文 参考文献 老年麻醉患者应用喉罩机械通气的观察 张胜 母怡 　　（苍溪县第二人民医院 四川 广元 628400） 　　【摘要】 目的：观察分析老年麻醉患者应用喉罩和常规气管内插管两种人工气道机械通气时的心血管反应、通气效果和并发症。方法：将136例腹腔镜下胆囊切除术老年麻醉患者随机分为喉罩组和气管内插管组。常规静脉麻醉诱导后，行喉罩或气管导管插入，观察记录各患者插罩（插管）前后和拔罩（拔管）前后心率（HR）、平均动脉血压（MAP）、异常心律、指血氧饱和度（SpO2）、呼气末二氧化碳（PetCO2）和漏气等指标变化情况，同时记录患者呕吐返流和咳嗽咽痛等不良并发症。结果：喉罩组在插罩前后和拔罩前后HR、MAP、异常心律变化无统计学差异（Pgt;0.05）；而导管组这3个指标在插管前后变化有差异（Plt;0.05）；插管组比插罩组漏气率高（Plt;0.05），呕吐返流和咳嗽咽痛并发症也较多（Plt;0.05）；但SpO2和PetCO2在各组内比较和组间比较无差异（Pgt;0.05）。结论：喉罩式人工气道机械通气有更少的心血管应激反应，可有效维持患者平稳的血液动力学，也能保障有效通气，且并发症少，具有操作便捷、安全性较高，可较好的应用于临床。 　　【关键词】 老年麻醉;喉罩;气管导管;通气;血液动力学 　　【中图分类号】R614 【文献标识码】A 【文章编号】2095-1752（2016）05-0042-02 　　Application of laryngeal mask anesthesia elderly patients observation of mechanical ventilation Zhang Sheng, Wu Yi. 　　The Second Peoples Hospital of Cangxi County, Sichuan, Guangyuan 628400, China 　　【Abstract】 Objective Analyze the application of laryngeal mask anesthesia elderly patients and normal endotracheal intubation the cardiovascular reaction of two kinds of artificial airway mechanical ventilation, ventilation effect and complications. Methods The 136 cases of laparoscopic cholecystectomy in elderly patients with anesthesia were randomly divided into laryngeal mask and intubation group. Results Laryngeal mask group before and after the plug cover and pull out cover of HR, MAP, abnormal heart rhythm changes before and after no statistical difference (P gt; 0.05); The three indexes before and after intubation and intubation group changes have difference (P lt; 0.05); Intubation group than laryngeal mask high air leakage rate (P lt; 0.05), vomiting, regurgitation and cough sore throat or more complications (P lt; 0.05). Conclusions Artificial mechanical ventilation airway, laryngeal mask which has less cardiovascular stress reaction, can effectively maintain a stable hemodynamics, can ensure the effective ventilation, and fewer complications, convenient operation and high safety, can be applied to clinical. 　　【K