喉罩在小儿疝气腹腔手术中的应用研究

目的探讨喉罩在小儿疝气腹腔手术中的应用效果和安全性。方法回顾性分析2011年4月至2012年3月120例美国麻醉医师协会（ASA）分级I～Ⅱ级、在全身麻醉下接受腹腔镜手术患儿的临床资料，将120例患儿随机分为喉罩组和气管插管组，各60例。记录患儿麻醉诱导前（T0）、插入喉罩／气管导管前（T1）、插入喉罩，气管导管后即刻（Y2）、插入喉罩／气管导管后10min（T3）、拔管后即刻（T4）的收缩压（SBP）、舒张压（DBP）及心率（HR），同时监测并记录患儿＇-3时的血氧饱和度、呼气末二氧化碳分压、气道压力、拔管时间、复苏时间，并观察患儿并发症发生情况。结果气管插管组T2与T4时SBP、DBP、HR较R时有明显升高，差异有统计学意义（P〈0．05）。T2、T4时气管插管组SBP、DBP和HR均明显高于喉罩组，差异有统计学意义（P〈0．05），其他时点两组SBP、DBP、HR比较，差异无统计学意义（P〉0．05）。喉罩组的拔管时间、复苏时间及麻醉用药量均优于气管插管组．差异有统计学意义（P〈0．05）。结论在小儿疝气腹腔镜术中，喉罩是一种安全、有效的气道管理方式。

Application research of laryngeal mask in abdominal operation of infantile hernia

Objective To explore the application effect and safety of laryngeal mask in abdominal surgery of infantile hernia. Methods Retrospective analysis was conducted on clinical data of 120 children with laparoscopic surgery under general anesthesia and classified by American Society of Anesthesiologists（ASA） from grade I to grade Ⅱ from April 2011 to March 2012. The patients were randomly divided into the laryngeal mask group and endotracheal intubation group, 60 cases in each group. To record the systolic blood pressure （SBP）, diastolic blood pressure （DBP） and heart rate （HR） before induction of anesthesia （To）, before insertion of laryngeal mask/endotrachea] tube （TI）, immediately after insertion of laryngeal mask/endotracheal tube （T2）, 10 minutes after insertion of laryngeal mask/endotracheal tube （T3） and imediately after extubation （T4） ;simultaneously to monitor and record oxygen saturation, end-tidal carbon dioxide, airway pressure, time to extubation,recovery time, and to observe the compli- cations of patients. Results Intubation group on T2 and T4, SBP, DBP and HR was significantly higher than those on To with statis- tically significant difference （P〈0.05）. The SBP, DBP, and HR in intubation group on T2 and T4 were significantly higher than those in laryngeal mask group（P〈O.05 ）, the other point in the two groups on SBP, I）BP and HR had no statistically significant difference （P〈0.05）. The extubation time, recovery time and anesthetic dose in laryngeal mask group were superior to endotrached group with statistically significant difference （P〈0.05）. Conclusion In the pediatric hernia laparoscopic surgery, the laryngeal mask is a safe amt effective way of airway management.