本文關(guān)鍵詞：喉罩通氣應(yīng)用于老年患者腹部手術(shù)麻醉對(duì)術(shù)后肺部并發(fā)癥的影響　出處：《上海醫(yī)學(xué)》2015年04期 　論文類型：期刊論文

  更多相關(guān)文章： 喉罩 管插管 年患者 后肺部并發(fā)癥

【摘要】：目的隊(duì)列分析行腹部手術(shù)的老年患者術(shù)中喉罩通氣與氣管插管對(duì)術(shù)后肺部并發(fā)癥和患者病死率的影響。方法收集上海東方肝膽外科醫(yī)院2010年1月—2013年7月間年齡65歲、于全身麻醉下?lián)衿谛懈共渴中g(shù)的患者的臨床資料,將術(shù)中使用喉罩通氣的患者列入喉罩組,使用氣管插管通氣的患者列入氣管插管組,比較兩組間患者的一般情況。收集并比較術(shù)后入ICU且需行機(jī)械通氣患者的臨床資料,以及術(shù)后入ICU且需行機(jī)械通氣患者的肺部并發(fā)癥情況。結(jié)果應(yīng)用醫(yī)院信息系統(tǒng)(HIS)共搜索到符合本研究納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)的患者2 629例,其中喉罩組1 297例、氣管插管組1 332例,兩組間患者的性別構(gòu)成、年齡、體重、術(shù)前血紅蛋白(Hb)水平、美國麻醉醫(yī)師協(xié)會(huì)(ASA)分級(jí)構(gòu)成、術(shù)中出血量,以及術(shù)中輸血和輸液量的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05)。術(shù)后需入ICU且需行機(jī)械通氣的患者109例,喉罩組58例、氣管插管組51例,兩組間患者的性別構(gòu)成、年齡、體重、平均住院天數(shù)、ICU住院天數(shù)、因肺部并發(fā)癥和其他原因入ICU的構(gòu)成比、ICU病死率,以及術(shù)后最高急性生理與慢性健康評(píng)分(APACHEⅡ評(píng)分)的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05),喉罩組術(shù)后最高白細(xì)胞計(jì)數(shù)顯著高于氣管插管組(P0.05)。喉罩組術(shù)后肺不張和肺栓塞發(fā)生率均顯著低于氣管插管組(P值均0.05),兩組間肺部感染、急性呼吸窘迫綜合征(ARDS)和(或)急性肺損傷(ALI)、胸腔積液發(fā)生率的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05)。結(jié)論與氣管插管通氣比較,喉罩通氣并不能減少老年患者腹部手術(shù)后肺部并發(fā)癥和死亡的發(fā)生。
[Abstract]:Objective to analyze the effects of laryngeal mask ventilation and tracheal intubation on postoperative pulmonary complications and mortality in elderly patients undergoing abdominal surgery. Methods from January 2010 to January 2010, Shanghai Oriental Hepatobiliary surgery Hospital. The age was 65 years between July and 3 years. The clinical data of patients undergoing elective abdominal surgery under general anesthesia were divided into laryngeal mask group and tracheal intubation group. To collect and compare the clinical data of patients who entered ICU and needed mechanical ventilation after operation. Results 2629 patients who met the criteria of inclusion and exclusion of this study were found by hospital information system (HIS). There were 1 297 cases in laryngeal mask group and 1 332 cases in tracheal intubation group. The American Association of Anesthesiologists (ASA) was classified as the composition of the intraoperative bleeding volume. There was no significant difference in blood transfusion and infusion volume during operation (P < 0.05). There were 109 patients who needed ICU and needed mechanical ventilation after operation, 58 patients in laryngeal mask group and 51 patients in tracheal intubation group. The sex composition, age, weight, average length of stay in ICU were higher than those in ICU because of pulmonary complications and other reasons. There was no significant difference between the highest acute physiological and chronic health score and Apache 鈪，

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