本文選題：ProSeal喉罩　切入點：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氣道管理的效果和安全性。 方法：選擇美國麻醉學(xué)會Ⅰ-Ⅱ級行婦科腹腔鏡全子宮切除術(shù)手術(shù)患者40例（ASAI-Ⅱ級），隨機分為兩組。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)測記錄插管／喉罩前后HR、MAP變化，二氧化碳氣腹前后的血氣分析變化；分別于入室后（T0）、氣腹前（T1）、氣腹30min（T2）、氣腹60min(T3)、氣腹后20min(T4)抽取橈動脈血行血氣分析，并記錄同一時刻PetCO2值。比較兩組患者在不同時點的PetCO2值與動脈血二氧化碳分壓（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、血流動力學(xué)平穩(wěn)、并發(fā)癥少的優(yōu)點。
[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)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R614

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