不同剂量右美托咪定干预七氟醚麻醉患儿苏醒期躁动的应用研究.docVIP

Proseal喉罩与气管插管用于合并上呼吸道感染患儿麻醉期间气道管理效果的比较 肖春龙，赵婷，张应平 （宝鸡市中医医院 麻醉科，陕西 宝鸡，721001） [摘 要]目的 比较Proseal喉罩与气管插管用于合并上呼吸道感染（URI）患儿麻醉期间气道管理的效果。方法 纳入126例合并有轻度至中度上呼吸道感染且须在全麻下行腹部开放性手术患儿，依照随机数字表法分为Proseal喉罩组和气管插管组。气管插管组采取常规气管插管，Proseal喉罩组采取置入合适型号Proseal喉罩。分别监测平均动脉压(MAP)、心率 (HR)、血氧饱和度(SpO2)、呼气末二氧化碳分压（PetCO2）变化。观察并记录两组患儿在麻醉复苏期出现的并发症以及术后24h的呼吸道感染症状等情况。结果 两组患儿MAP和HR均有一定升高，T5时点 Proseal喉罩组MAP明显低于气管插管组，差异具有统计学意义（p＜0.01）。T3和T5时点Proseal喉罩组HR明显低于气管插管组，差异具有统计学意义（p＜0.01）。两组患儿SpO2和PetCO2各时点差异比较无统计学意义（p＞0.05）。Proseal喉罩组与气管插管组患儿麻醉苏醒期喉痉挛、支气管痉挛、低氧血症、气道梗阻、呛咳等并发症发生率比较明显较低，差异具有统计学意义（p＜0.05）；两组屏气30s以上发生率比较无明显差异，差异无统计学意义（p＞0.05）。Proseal喉罩组与气管导管组患儿术后24h，上呼吸道感染流涕、鼻塞、咳嗽、咳痰、痰鸣音、喘鸣、肺部湿啰音等症状比较明显较低，差异具有统计学意义（p＜0.05）；两组发热、流涕症状比较，差异无统计学意义（p＞0.05）。结论 对于URI须行手术治疗的患儿，应用Proseal喉罩进行麻醉管理，具有操作简单，置管方便，对患儿刺激性小，患儿耐受性好，术中血流动力学指标平稳，麻醉不良事件发生率低，术后24h上呼吸道感染症状轻等优势，值得临床推广应用。 [关键词]Proseal喉罩；气管插管；麻醉气道管理；上呼吸道感染；腹部开放性手术 [中图分类号]R614.2 Comparison of efficacy of Proseal laryngeal mask airway and general anesthesia with endotracheal intubation in children with upper respiratory infection XIAO Chun-long, ZHAO Ting, ZHANG Ying-ping (Department of Anesthesiology, Baoji City Traditional Chinese Medicine Hospital, Baoji 721001, China) [Abstract] Objective Comparison of efficacy of Proseal laryngeal mask airway and endotracheal intubation for upper respiratory infection (URI) in children with airway management. Methods In 126 cases with mild to moderate upper respiratory infection and be under general anesthesia in children with open abdominal surgery.Under conditions prescribed by the random number table,the children were randomly divided into Proseal laryngeal mask airway and endotracheal intubation group.The endotracheal intubation group took endotracheal intubation,the Proseal laryngeal mask airway group took the appropriate Proseal laryngeal mask airway.The indexes of mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2), end-tidal carbon dioxide partial pressure (PetCO2) were monitored.Observed and recor