摘要
目的观察甲亢患者甲状腺次全切除术中应用喉罩通气行全身麻醉对血液动力学的影响。方法40例甲亢甲状腺次全切除术患者,随机分为气管插管组(T组)与喉罩置入组(L组),每组20例。气管插管用喉镜明视插入法,喉罩按顺行盲探置入口底。全部患者均于麻醉诱导后插管(或罩入喉罩)前(T0)、气管插管(或罩入)后即刻(T1)、1 m in(T2)、3 m in(T3)、5 m in(T4)各时间点监测SBP、MAP、HR值。术后24 h随访记录患者咽痛、声嘶的发生率。结果L组在置入喉罩前后各时点SBP、MAP、HR无显著性变化(P>0.05),T组在插管后各时点与T0相比SBP、MAP、HR均明显升高(P<0.05)。T组T1、T2、T3各时点SBP、MAP、HR均高于L组(P<0.05)。术后24 h咽痛、声嘶副作用发生率,T组明显高于L组(P<0.05)。结论喉罩对血流动力学影响小、安全性高、副作用用少,比气管插管更适合于甲亢患者甲状腺手术的全麻要求。
Objective To study the effect of laryngeal mask airway（LMA） for bemodynamie changes in general anesthesia for subtotal thyroideetomy of hyperthyroid patients. Methods 40 hyperthyroid patients who underwent subtotal thyroideetomy were randomly divided into 2 groups with 20 eases each, including group T with tracheal intubation by laryngoscopy and group L with blind antegrade LMA insertion to mouth floor. The values of SBP, MAP and HR were measured at the time before tracheal intubation or LMA insertion（T0 ） , intubafion or LMA positing（T1 ）, 1 minutes （T2）, 3 minutes （T3 ） and 5 minutes （T4） after intubation or LMA placing. And morbidity rate of side-injury such as pharyngodynia and hoarseness was recorded during 24 hours after operation. Results There was no obvious bemodynamie change at To - T4 among the group L （ P ：〉 0. 05） , while the SBP, MAP and HR at T1- T4 were significantly higher than those of TO in group T（ P 〈 0.05）. Comparing with group L, the value of SBP, MAP and HR were remarkably higher in group T at Tl - T3. The morbidity rate of pharyngodynia and hoarseness after operation was obviously higher in group T than that of group L （ 30% vs. 5 %, P 〈 0.05 ）. Conclussion LMA could be more suitable than tracheal intubation in subtotal thyroidectomy for hyperthyroid patients, with less hemodynamie effect, higher safety and less side-effect.
出处
《中国现代手术学杂志》
2007年第3期215-217,共3页
Chinese Journal of Modern Operative Surgery
关键词
麻醉
全身
喉面罩
插管法
气管内
甲状腺切除术
anesthesia, general
laryngeal masks
intubation, intratracheal
thyroideetomy
