经口咽通气道面罩加压给氧在腹腔镜胆囊切除术中的应用

目的:探讨口咽通气道在腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中应用的有效性和通气效果。方法:选择我院100例择期行LC的患者,ASAⅠ~Ⅱ级,20~76岁,随机分为气管导管组(T组)和口咽通气道组(M组),观察患者入室(T1)、插管前(T2)、插管后(T3)、气腹前(T4)、气腹后5min(T5)、气腹结束后(T6)的HR、BP、SpO2、呼气末二氧化碳分压(PETCO2)和气道峰值压力,在T1、T3和T6分别抽取动脉血进行血气分析。记录气腹时间和麻醉时间及拔管和术后并发症。结果:两组患者一般情况、术中通气情况及血气分析差异均无统计学意义。T组插管时循环系统波动大(P0.05),拔管时呛咳发生率高(P0.01),术后咽痛率高(P0.01)。结论:口咽通气道用于LC简便、实用、微创。

Application of face mask pressurized ventilation through oropharyngeal airway in laparoscopic cholecystectomy

Objective:To discuss the efficacy and venting effect of oropharyngeal airway in laparoscopic cholecystectomy(LC).Methods:One hundred patients(20-76 years)who would receive selective LC,ASA Ⅰ-Ⅱ,were randomly divided into tracheal catheter group(T group)and oropharyngeal airway group(M group).HR,BP,SpO2,PETCO2 and peak inspiratory pressure were observed when patients were sent in surgery room(T1),pre-intubation(T2),post-intubation(T3),pre-pneumoperitoneum(T4),the 5th min during pneumoperitoneum(T5),and post-pneumoperitoneum(T6).Arterial bloods were collected for blood gas analysis at T1,T3 and T6,respectively.Time of pneumoperitoneum and anaesthesia,extubation and postoperative complications were recorded.Results:The difference of general state of health,venting during surgery and blood gas analysis between two groups were not statistically significant.Significant fluctuation of circulating system when intubating(P<0.05),high bucking incidence rate when extubating(P<0.01)and high postoperative pharyngodynia incidence rate(P<0.01)were observed in T group.Conclusions:Oropharyngeal airway is simple,effective and mini-invasive for LC.