摘要
目的:探究普通喉罩通气麻醉对腹腔镜卵巢肿瘤切除术患者脑氧代谢率、血流动力学及血清去甲肾上腺素(NE)水平的影响。方法:将在本院进行腹腔镜卵巢肿瘤切除术的患者126例按照麻醉方式不同分为气管插管组(63例)和普通喉罩组(63例),分别给予气管插管通气麻醉或普通喉罩通气麻醉。比较两组患者血流动力学指标[收缩压(SBP)、心率(HR)、舒张压(DBP)、平均动脉压(MAP)],血清NE水平,脑氧代谢率[脑氧摄取率(CEO2)、呼气末二氧化碳(ETCO2)],术后并发症及苏醒时间。结果:普通喉罩组苏醒时间(5.2±1.1 min)低于气管插管组(10.3±2.2 min)(P<0.05);两组t2、t3时SBP、HR、DBP、MAP水平均高于t1时,与t2时相比t3时两组SBP、DBP、MAP水平均降低、HR水平升高(P<0.05),且t2、t3时普通喉罩组SBP、HR、DBP、MAP水平高于气管插管组(均P<0.05);两组血清NE水平t1时最低、t3时次之、t2时最高,且t2、t3时普通喉罩组低于气管插管组(均P<0.05);气管插管组各时点ETCO2、CEO2水平无差异(P>0.05),t2、t3时普通喉罩组ETCO2水平高于气管插管组,CEO2水平低于气管插管组(P<0.05);术后普通喉罩组咽喉粘膜出血、咳痰与咳嗽、咽痛、声音嘶哑等并发症发生率(7.9%)低于气管插管组(22.2%)(P<0.05)。结论:普通喉罩通气麻醉用于腹腔镜卵巢肿瘤切除术患者可有效改善患者血流动力学及脑氧代谢率,降低NE水平及术后并发症发生率,减轻应激反应,缩短苏醒时间。
Objective:To explore the effects of general laryngeal mask airway anesthesia used in the patients who undergone laparoscopic ovarian tumor resection on their cerebral oxygen metabolism rate,hemodynamics,and serum norepinephrine(NE)level.Methods:126 patients who undergone laparoscopic ovarian tumor resection were divided into group A(63 cases with tracheal intubation for anesthesia)and group B(63 cases with general laryngeal mask for anesthesia)according to different anesthesia methods.The values of hemodynamic indexes[systolic blood pressure(SBP),heart rate(HR),diastolic blood pressure(DBP),and mean arterial pressure(MAP)],serum NE level,cerebral oxygen metabolism rates[fractional con-centration of end-tidal carbon dioxide(ETCO2)and cerebral extraction of oxygen(CEO2)],postoperative complications rate,and awakening time of the patients were compared between the two groups.Results:The awakening time(5.2±1.1 min)of the patients in group B was significant shorter than that(10.3±2.2 min)of the patients in group A(P<0.05).The values of SBP,HR,DBP,and MAP at T2 and T3 of the patients in both groups were significant higher than those at T1.The values of SBP,DBP,and MAP at T3 of the patients in both groups were significant lower than those at T2,but the HR value was significant higher(P<0.05).The values of SBP,HR,DBP,and MAP at T2 and T3 of the patients in group B were significant higher than those of the patients in group A(all P<0.05).The serum NE level at T1 of the patients in the two groups was the lowest,followed by that at T3,and that at T2 was the highest,and the serum NE level at T2 and T3 of the patients in group B was significant lower than that of the patients in group A(all P<0.05).The levels of ETCO2 and CEO2 of the patients in group A had no significant different at T1,T2,and T3(P>0.05).The ETCO2 level at T2 and T3 of the patients in group B was significant higher than that of the patients in group A,but the CEO2 level at T2 and T3 of the patients in group B was significant lower than that of the patients in group A(P<0.05).The incidence of postoperative complications,such as throat mucosal bleeding,sputum and cough,sore throat,and hoarseness,of the patients in group B was 7.9%,which was significant lower than that(22.2%)of the patients in group A(P<0.05).Conclusion:General laryngeal mask airway anesthesia used during laparoscopic ovarian tumor resection can effectively improve the hemodynamics and cerebral oxygen metabolism rate of the patients,can reduce their NE level,the incidence of postoperative complications,and the stress reaction,and can shorten their awakening time.
作者
季磊
肖冰冰
JI Lei;XIAO Bingbing(Jieshou People`s Hospital, Anhui Province, 236500)
出处
《中国计划生育学杂志》
2021年第8期1596-1600,共5页
Chinese Journal of Family Planning
关键词
腹腔镜卵巢肿瘤切除术
普通喉罩通气麻醉
气管插管通气麻醉
脑氧代谢率
血流动力学指标
去甲肾上腺素
Laparoscopic ovarian tumor resection
General laryngeal mask airway anesthesia
Tracheal intubation anesthesia
Cerebral oxygen metabolism rate
Hemodynamics index
Norepinephrine
