腹腔镜胆囊切除术喉罩通气的探讨（附1800例报告）

目的 喉罩通气代替插管用于腹腔镜胆囊切除术，探讨更适合快速短效，但心率、血压滚动大的腹腔镜术麻醉。方法 该手术１８００例，快速诱导后置喉罩通气。观察放置及通气情况，并从该组及同期插管病例各随机抽取４４例比较。结果：１８００例，９０％用３号，１０％用４号，顺利放入率９８％，调整后漏气率２．１％（３７／１８００）。抽样对比，插入后至气腹１０ｍｉｎ，心率、血压明显小于插管组（Ｐ〈０．０１或Ｐ〈０．０５）

VENTILATION WITH LARYNGEAL MASK IN LAPAROSCOPIC CHOLECYSTECTOMY

Objective Using laryngeal mask to replace intubation in laparoscopic cholecystectomy to study the anesthesia which requires short time but the heart rate and blood pressure are unstable. Methods Laparoscopic cholecystectomy with laryngeal mask ventilation was used in 1800 cases after fast induction.Placement and ventilation were observed.Moreover,44 cases from this group and 44 from intubation were compared. ResultWT5BZAmong these 1800 cases,90% patients used No.3 laryngeal mask and 10% No.4 laryngeal mask.The rate of smooth placement is 98%,the rate of air leak after adjustment is 2.1%(37/1800).Sample comparison:After placement ten minutes,the heart rate and blood pressure in the laryngeal mask group are obviously lower than that in intubation gruop( P< 0.01 or P<0.05).The rate of inadequate anesthesia reaction during operation and jnjures of mouth,pharynx and trachea are 2%,13.6% and 22.7%,40.9% respectively in two groups ( P <0.01).There are no lack of oxygen and accumulation of carbon dioxide(LaparoscopyP >0.05). Conclusion It is conveninent to use laryngeal mask ventilation with the result of stable anesthesia,and no influence on lung ventilation.So it is suitable in this operation.