【摘要】 目的:比较Supreme喉罩和气管插管对老年乳腺癌根治术病人血流动力学的影响。方法:择期乳腺癌根治术全麻病人80例,年龄60～75岁,随机均分为喉罩组(L组)和气管内插管组(T组)。全麻诱导后插入Supreme喉罩/气管导管。记录一次插入成功率及所需时间;记录两组病人全麻诱导前(T0)、插入喉罩/气管导管前(T1)、插入即刻(T2)、插入喉罩/气管导管后1min(T3)、3min(T4)、5min(T5)和拔管后即刻(T6)记录收缩压(SBP)、舒张压(DBP)、心率(HR)。术中血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)和气道峰压(Ppeack);观察术中误吸、拔除喉罩/气管导管时呛咳及拔除喉罩/气管导管后的低氧血症、咽痛情况。结果:与T组比较,L组喉罩一次插入成功率较高(P<0.05)、插入时间明显缩短(P<0.01);两组病人T1时SBP、DBP显著低于T0(P<0.05),T组病人T2、T3、T6时SBP、DBP、HR较T0显著升高(P<0.05);L组T2、T3时SBP、DBP、HR显著低于T组(P<0.05),L组T6时SBP和HR显著低于T组(P<0.05);拔除喉罩后低氧血症及咽喉痛发生率减少(P<0.01),且无呛咳病例。两组术中SpO2、PETCO2和Ppea c k均在正常范围内,均无误吸发生。结论:Supreme喉罩操作简便易行,插入/拔除操作对血流动力学无明显影响,不引起呛咳,术后不良反应少,用于老年乳腺癌根治术病人优于气管插管。更多还原

【Abstract】 Objective:To compare the effects and safety of laryngeal mask airway supreme and endotracheal intubation in the elderly patients undergoing radical mastectomy.Methods:Eighty patients with breast cancer undergoing selective mastectomy were randomly divided into two grups with 40 cases each.The patients in group L were ventilated with laryngeal mask and those in group T were given conventional tracheal intubation as the controls.Patients’SBP,DBP,HR,SpO2,PETCO2 and Ppeack were recorded before the induction of general anesthesia(T0),before inserting laryngeal mask airway/tracheal tube(T1),inserting laryngeal mask airway/tracheal tube immediately(T2),after inserting laryngeal mask airway/tracheal tube 1 min(T3),3 min(T4),5min(T5),uprooting laryngeal mask airway/tracheal tube immediately(T6),The complications of anesthesia were recorded included bucking,countercurrent,aspiration and postoperative pharyngolaryngeal adverse events during each operation.Results:Compared with the T group,L group laryngeal mask insert a high success rate(P<0.05),insert a short time(P<0.01).The SBP,DBP of the two groups patients at T1 was significantly lower than T2(P<0.05),T group patients T2.T3 and T6 point of the SBP,DBP and HR significantly increased compared with T0(P<0.05),the SBP,DBP and HR of group L patients T2.T3 point significantly lower than in group T(P<0.05),the SBP and HR of group L patients T6 point significantly lower than in group T(P<0.05),The patients’ hypoxemia during extubation and postoperative sore throat in group L were found significantly lower than those in group T(P<0.01).SpO2,PETCO2 and Ppeack in the two groups of patients are within the normal range,and less than absorption occurred.Conclusion: Supreme laryngeal mask airway are not only hemodynamic relatively stable but also reduce the perioperative associated complications,whose advantages are obviously higher than endotracheal tube.更多还原