本文選題：ProSeal喉罩　切入點(diǎn)：氣管插管　出處：《石河子大學(xué)》2014年碩士論文

【摘要】：目的：比較婦科腹腔鏡手術(shù)應(yīng)用第三代喉罩(ProSeal laryngeal mask airway，PLMA)與氣管插管全身麻醉時(shí)氣道管理的效果和安全性。 方法：選擇美國(guó)麻醉學(xué)會(huì)Ⅰ-Ⅱ級(jí)行婦科腹腔鏡全子宮切除術(shù)手術(shù)患者40例（ASAI-Ⅱ級(jí)），隨機(jī)分為兩組。P組使用喉罩通氣下靜脈復(fù)合全麻（20例），T組為氣管插管通氣下靜脈復(fù)合全麻（20例），監(jiān)測(cè)記錄插管／喉罩前后HR、MAP變化，二氧化碳?xì)飧骨昂蟮难獨(dú)夥治鲎兓环謩e于入室后（T0）、氣腹前（T1）、氣腹30min（T2）、氣腹60min(T3)、氣腹后20min(T4)抽取橈動(dòng)脈血行血?dú)夥治�，并記錄同一時(shí)刻PetCO2值。比較兩組患者在不同時(shí)點(diǎn)的PetCO2值與動(dòng)脈血二氧化碳分壓（arterialpartialpressure of carbonioxide，PaCO2）值以及術(shù)中、術(shù)后發(fā)生各種并發(fā)癥的例數(shù)。 結(jié)果：P組置入喉罩前后HR、MAP無(wú)明顯變化，，而T組插管后HR、MAP顯著高于插管前（P0.01)；氣腹后P、T組的PaCO2均顯著高于氣腹前（P0.01)；PetCO2值及PaCO2值在T2和T4時(shí)間段的相關(guān)性最差；T組咽喉并發(fā)癥的發(fā)生顯著高于P組（P0.05)。 結(jié)論：婦科腹腔鏡手術(shù)中使用第三代喉罩與氣管插管通氣效果一致，具有安全性好、血流動(dòng)力學(xué)平穩(wěn)、并發(fā)癥少的優(yōu)點(diǎn)。
[Abstract]:Objective: to compare the efficacy and safety of the third generation laryngeal mask proseal laryngeal mask airway anesthesia in gynecological laparoscopic surgery.Methods: 40 patients undergoing gynecological laparoscopic total hysterectomy were randomly divided into two groups. Group P was treated with laryngeal mask ventilation combined with general anesthesia and 20 cases were treated with laryngeal mask ventilation combined with general anesthesia under endotracheal intubation.The changes of HRMAP before and after intubation / larynx mask were monitored in 20 patients with intravenous combined general anesthesia.The changes of blood gas were analyzed before and after pneumoperitoneum, including T _ 0, T _ (1), T _ (2) T _ (2), T _ (3) at 60 min after pneumoperitoneum and T _ (4) at 20 min after pneumoperitoneum), and the PetCO2 values at the same time were recorded.The values of PetCO2 and arterial partial pressure of carbon dioxide of carbonioxide-Paco _ 2 were compared between the two groups at different time points, and the number of complications occurred during and after operation.Results there was no significant change in HRMAP before and after placement of laryngeal mask in group 1: PHowever, after intubation, HRMAP in group T was significantly higher than that before intubation (P 0.01), PaCO2 in group T was significantly higher than that in group P 0.01 and PaCO2 in T 2 and T 4. The incidence of larynx complications in group T was significantly higher than that in group P (P 0.05).Conclusion: the third generation laryngeal mask is the same as tracheal intubation in gynecological laparoscopic surgery, which has the advantages of good safety, stable hemodynamics and less complications.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王麗冰,俞增貴,李傳醋,林水雄;20 例腹腔鏡膽囊切除術(shù)中 PetCO_2 與 PaCO_2 的關(guān)系探討[J];福建醫(yī)藥雜志;1997年02期

2 許海芳;喉罩及插管型喉罩的進(jìn)展[J];國(guó)外醫(yī)學(xué).麻醉學(xué)與復(fù)蘇分冊(cè);2000年01期

3 房明;;腹腔鏡手術(shù)中氣腹對(duì)循環(huán)、呼吸、神經(jīng)內(nèi)分泌的影響[J];吉林醫(yī)學(xué);2007年16期

4 吳立新,于湘友,李春香,哈斯艷;喉罩在支氣管哮喘病人麻醉中的應(yīng)用[J];臨床麻醉學(xué)雜志;2005年06期

5 史東平;祝義軍;封衛(wèi)征;聞大翔;杭燕南;;食管引流型喉罩在腹腔鏡膽囊手術(shù)麻醉中的應(yīng)用[J];臨床麻醉學(xué)雜志;2006年07期

6 張鴻;王東信;;婦科腹腔鏡手術(shù)術(shù)后惡心嘔吐的臨床研究[J];臨床麻醉學(xué)雜志;2009年11期

7 柴小青;朱運(yùn)蓮;魏昕;陳昆洲;;Supreme喉罩在老年病人麻醉中的應(yīng)用[J];臨床麻醉學(xué)雜志;2011年01期

8 阮駱陽(yáng);曹金良;許曉夢(mèng);;SLIPA喉罩用于腹腔鏡手術(shù)的可行性和安全性[J];臨床麻醉學(xué)雜志;2011年05期

9 敖翔,陸誠(chéng),段宏偉;腹腔鏡膽囊切除術(shù)二氧化碳?xì)飧箤?duì)動(dòng)脈血?dú)夂秃魵饽┒趸挤謮旱挠绊慬J];中國(guó)臨床醫(yī)學(xué);2004年04期

10 王聰;張立民;陳衛(wèi)民;龍波;;肥胖患者在側(cè)臥位手術(shù)中應(yīng)用雙管喉罩行壓力控制通氣協(xié)同間歇性膨肺有效改善呼吸功能的研究[J];實(shí)用藥物與臨床;2013年03期

本文編號(hào)：1729583