目的：探究老年人腹腔镜胆囊手术分别开展喉罩麻醉和气管内插管麻醉对其呼吸及循环功能的影响，并为这类患者临床麻醉方案的最优化选择积累经验。方法选取于2012年4月至2014年5月收治的84例行腹腔镜胆囊摘除术老年患者，利用随机数字表法进行分组，分别设为研究组和对照组，每组各42例。其中对照组开展气管内插管麻醉，研究组则开展喉罩全麻。记录两组患者围手术期各监测时间点的循环、呼吸功能及并发症发生率，并对比分析。结果两组插入前的心率（ HR）及平均动脉压（ MAP）值差异无统计学意义（ P >0.05）；研究组在插入后即刻、插入后3 min、拔除前即刻、拔除后即刻、拔出后3 min的HR及MAP值均低于对照组，差异有统计学意义（ P 0.05）；研究组在插入后3 min及拔除前即刻气道压力（PAW）及呼气末二氧化碳分压（PETCO2）差异无统计学意义（ P >0.05）。研究组麻醉期间不良反应发生率低于对照组（16.7%比47.6%），差异有统计学意义（ P 0. 05). Study group after insertion,removal of 3min,im-mediately after insertion immediately before,immediately after removal,pull out the HR and MAP values of 3min were lower than those of the con-trol group. The difference was statistically significant( P 0. 05). The study group after insertion and removal of 3 min immediately be-fore PAW and PETCO2 values had no significant difference( P >0. 05). The occurrence rate in the research group of anesthetic adverse reactions was 16. 7%(7/42),the control group the incidence of adverse reaction was 47. 6%(20/42). The difference was statistically significant( P <0. 05). Conclusion Laryngeal mask anesthesia in the elderly laparoscopic operation,compared with endotracheal intubation,can effectively re-duce the stress response to anesthesia operation,be conducive to the stability of circulatory and respiratory function,and security. This method is worthy of further promotion.
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