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喉罩在小儿舌系带矫正手术中的应用

         

摘要

Objective To discuss the feasibility of application of laryngeal mask airway(LMA)in pediatric corrective surgery of lingual frenum. Methods Retrospective study was conducted of 42 chil-dren using laryngeal mask airway in selective surgical correction of lingual frenum under general anesthe-sia in our hospital. The childrenˊs vital signs were recorded at five different time points:baseline before an-esthesia(T0),consciousness and eyelid reflex disappear just after anesthesia induction(T1),time right af-ter the LMA insertion(T2),3 ~ 5 min after beginning of operation(T3),and time at the extubation(T4). The success rate of first LMA insertion and the number of changing to other ventilation way were recorded. The shift of LMA and postoperative sore throat within 24h were recorded. Results The success rate of the first LMA insertion was 85. 71% . Intraoperative laryngeal mask airway leak and shift did not occur and the ventilation was also good. Vital signs of the children were stable during operation. The incidence of postop-erative sore throat was 15% within 24h. As to the heart rate,the vital signs of baseline T0 were significant-ly different from other time points(T1,T2,T3,T4). After the anesthesia,there were no significant differ-ences in heart rate among different time points(T1,T2,T3,T4). Compare with T2 and T3,the values of partial end expiratory pressure of CO2 at T0,T1,and T4 were significantly different. Compare with T0,the values of mean arterial pressure at T1,T2 and T3 were significantly different,but there was a significant difference in mean arterial pressure between T1 and T4. As to the pulse oxygen saturation,all the values were above 95% . Conclusion Laryngeal mask airway is a supraglottic airway management method. The advantages of fewer haemodynamic changes and postoperative complication are confirmed. It is feasible and safe for securing the airway in surgical correction of lingual frenum.%目的探讨喉罩在小儿舌系带矫正手术全身麻醉中的应用。方法择期行小儿舌系带矫正手术患儿42例。所有患儿均采用静吸复合麻醉,术中应用喉罩通气。监测入室后麻醉前(T0)、麻醉诱导后意识和眼睑反射消失时(T1)、喉罩置入后即时(T2)、术中3~5分钟(T3)、术毕拔出喉罩时(T4)5个时间点患儿生命体征。记录每例患儿喉罩首次置入成功率和喉罩置入失败改为其他通气方式的比例。记录术中喉罩有无移位情况及术后24小时咽痛不适的发生情况。结果42例患儿喉罩首次置入成功36例,成功率为85.71%。术中喉罩均未发生漏气、移位,通气良好。术中患儿生命体征平稳。术后24小时咽痛6例,发生率为15%。T0时心率与 T1、T2、T3、T4比较,差异有统计学意义( P <0.05)。T1、T2、T3、T4间两两比较,差异无统计学意义( P >0.05)。术中喉罩存在的两个时点(T2、T3)呼气末二氧化碳正压与喉罩不存在的3个时点(T0、T1、T4)比较,差异有统计学意义(P <0.05)。入室麻醉前 T0时点与麻醉后 T1、T2和 T3三个时点平均动脉压力比较,差异均有统计学意义(P <0.05)。T1和 T4时点平均动脉压力比较,差异有统计学意义(P <0.05,)。所有患者脉搏氧饱和度均在95%以上。结论喉罩应用于小儿舌系带矫正手术的全身麻醉,安全性高,术中麻醉维持平稳,术后并发症少,安全可行。

著录项

  • 来源
    《临床外科杂志》 |2016年第10期|792-794|共3页
  • 作者

    刘琼; 江辉;

  • 作者单位

    430030 武汉;

    华中科技大学同济医学院附属同济医院麻醉学教研室;

    430030 武汉;

    华中科技大学同济医学院附属同济医院麻醉学教研室;

  • 原文格式 PDF
  • 正文语种 chi
  • 中图分类
  • 关键词

    喉罩; 舌系带矫正手术;

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