SLIPA喉罩与气管插管对腹腔镜胆囊手术患者心血管应激反应的比较

摘要

Objective To compare the difference of cardiovascular responses between SLIPA Iaryngeal mask airway and endotracheal intubation in patients with laparoscopic cholecystectomy under general anaesthesia. Methods Sixty -five patients received laparoscopic cholecystectomy anesthesia were allocated randomly into SLIPA group (treated by Iaryngeal mask) and ET group (treated by endotracheal intubation). The mean arterial pressure (MAP) and heart rate (HR) were recorded before intubation (T1) and after intubation (T2), as well as before extubation (T3) and after ex-tubation (T4). Results In SLIPA group, HR and MAP at T2, T< were similar with that at T1, T3 (P>0.05); HR and MAP at T2, T4 in ET group were significantly higher than that at T1, T3 (P<0.05). Compared with ET group, the MAP and HR in SLIPA group was smoother than that in ET group (P<0.05). Conclusion Ventilation with SLIPA in patients with laparoscopic cholecystectomy under general anaesthesia is more effective than ET in keeping stable hemodynamics and producing less ardiovascular responses.%目的 探讨SLIPA喉罩与气管插管两种通气方式在全麻腹腔镜下胆囊手术患者心血管应激反应的差异.方法 选择我院择期全麻下腹腔镜胆囊手术患者65例,按照入院随机数字表随机分为喉罩组和气管插管组,喉罩组为置入SLIPA喉罩,气管插管组为插入气管导管,比较两组置罩管(罩)前后以及拔管(罩)前后HR和MAP变化以及波动幅度.结果两组置罩(管)前HR、MAP差异无统计学意义(P＞0.05)；喉罩组置/拔罩前后HR、MAP差异无统计学意义(P＞0.05)；气管插管组置/拔管前后HR、MAP差异有统计学意义(P＜0.05)；喉罩组置/拔罩前后HR、MAP波幅变化显著低于气管插管组,差异有统计学意义(P＜0.05).结论 SLIPA喉罩在麻醉过程中血流动力学平稳,机体应激反应轻,心率、血压波动幅度小,可望成为具有心血管基础疾病患者麻醉气道管理的一个新的选择.