喉罩联合无肌松技术对重症肌无力胸腺切除术患者血气指标、呼吸功能和并发症的影响

摘要

目的 研究喉罩联合无肌松技术对重症肌无力胸腺切除术患者血气指标、呼吸功能和并发症的影响.方法 选取2016年4月至2017年3月在该院行胸腺切除术的重症肌无力患者78例,根据随机数字法分为观察组和对照组,每组39例.观察组使用喉罩联合无肌松技术,对照组使用喉罩联合肌松技术.比较两组患者的血气指标、呼吸功能、术中麻醉用药量和术后苏醒情况、并发症.结果 麻醉前,两组患者动脉血二氧化碳分压(PaCO2)、血氧分压(PaO2)、脉搏血氧饱和度(SpO2)、pH 值等血气指标比较差异无统计学意义(P＞0 .05) ;拔管时,两组患者PaCO2、pH值比较差异无统计学意义(P＞0 .05) ,但观察组的PaO2、SpO2显著高于对照组(P＜0 .05).麻醉前,两组患者潮气量(VT)、补吸气量(TRV)、补呼气量(ERV)、残气量(RV)、肺活量(Vc)水平比较差异无统计学意义(P＞0 .05) ,拔管时观察组的V T、T RV、ERV、RV、Vc水平明显高于对照组(P＜0 .05) .观察组的清醒时间、拔管时间明显少于对照组(P＜0 .05) .观察组的并发症发生率明显低于对照组(P＜0 .05) .结论 喉罩联合无肌松技术能有效稳定重症肌无力胸腺切除术患者的呼吸功能,并不会对患者血气功能造成影响,降低术后并发症的发生率.%Objective To study the effect of laryngeal mask combined with muscle relaxant free technique in treatment of patients with myasthenia gravis thymectomy and its effects on blood gas index ,respiratory function and complications .Methods A total of 78 patients with myasthenia gravis who underwent thymecto-my from April 2016 to March 2017 ,those patients were divided into observation group and control group ac-cording to random number method .The observation group used laryngeal mask combined with muscle relaxant free technique ,the control group used laryngeal mask combined with muscle relaxant technique .The blood gas index ,respiratory function ,intraoperative anesthesia dose and postoperative awakening and complication were compared between the two groups .Results Before anesthesia ,there was no significant difference in PaCO2, PaO2,SpO2 and pH between the two groups (P＞0 .05) ,at extubation ,there was no significant difference in PaCO2,pH values between the two groups (P＞0 .05) ,but PaO2 and SpO2 in the observation group were sig-nificantly higher than those in the control group (P＜0 .05).Before anesthesia ,there was no significant differ-ence in the levels of tidal volume (VT) ,inspiratory volume (TRV) ,expiratory replacement volume (ERV) , residual volume (RV) ,vital capacity (Vc) between the two groups (P＞0 .05).The awake time and extuba-tion time of the observation group were significantly shorter than those of the control group (P＜0 .05).The incidence of complications in the observation group was significantly lower than that in the control group (P＜0 .05).Conclusion Laryngeal mask combined with no muscle relaxant free technique can effectively stabilize the respiratory function of patients with myasthenia gravis ,and does not affect the blood gas function and re-duce the incidence of postoperative complications .