喉罩全麻与气管插管全麻在小儿麻醉中的应用效果观察

摘要

Objective:To compare the difference of LMA general anesthesia and endotracheal intubation general anesthesia in pediatric anesthesia.Methods:90 cases of patients who would receive elective surgery of general anesthesia in a hospital from January 2015 to December 2015 were selected and randomly divided into laryngeal mask group and endotracheal intubation group,with 45 cases in each group.Then compared the changes of HR,SBP,DBP,SpO 2 and the incidence of complications of two groups immediately after intuba-tion,at 3 min before extubation and immediately after extubation.Results:Immediately after intubation,the ascensional ranges of HR,SBP,DBP in laryngeal mask group were significantly lower than those of endotra-cheal intubation group (P <0.05 );At 3 min before extubation,the hemodynamics of two groups remained stable,with good ventilation.After extubation,the ventilatory function of laryngeal mask group was better than that of endotracheal intubation group (P <0.05).After extubation,there was no case of laryngeal spasm in both two groups,and there was no significant difference in the incidence of regurgitation,aspiration and gaseous distention of two groups (P >0.05 ).The throat discomfort rate of endotracheal intubation group (31.1%)was significantly higher than that of laryngeal mask group (P <0.05).Conclusion:The application of LMA general anesthesia for pediatric anesthesia has good safety,which can ensure the premise of maintaining effective ventilation to reduce the stimulation and keep a relatively stable hemodynamics,with less postopera-tive complications,and is better than endotracheal intubation general anesthesia.%目的：：对比喉罩全麻与气管插管全麻在小儿麻醉中的应用效果差异。方法：选取2015年1月~2015年12月某院90例择期行全麻手术的患儿，随机分为喉罩组和气管插管组，每组45例，比较两组麻醉插管后即刻、拔管前3 min、拔管后即刻的心率(HR)、收缩压(SBP)、舒张压(DBP)、脉搏氧饱和度(SpO 2)变化情况及并发症发生率的差异。结果：插管后即刻，喉罩组 HR、SBP、DBP 上升幅度明显低于气管插管组(P <0.05)；两组拔管前3min 血流动力学维持稳定，通气良好，拔管后，喉罩组通气功能优于气管插管组(P <0.05)；拔管后两组患儿均无一例出现喉痉挛，喉罩组反流、误吸及胃胀气的发生率与气管插管组比较无统计学差异(P >0.05)，气管插管组咽部不适的发生率为31.1%，明显高于喉罩组(P <0.05)。结论：喉罩全麻用于小儿麻醉中具有良好的安全性，可在确保维持有效通气的前提下减少刺激，维持血流动力学相对稳定，术后并发症少，优于气管插管全麻。