加强型喉罩与气管插管对眼科手术中血流动力学、呼吸动力学及术后复苏质量的影响

目的对比加强型喉罩及气管导管应用于眼科手术对术中患者的血流动力学及呼吸力学和术后复苏质量的效果。方法选取全麻条件下行眼科手术患者60例,采用随机数字表法将其分为气管插管组(TI组)以及喉罩组(FRLMA组),每组30例。比较不同时间点两组血流动力学指标变化情况及两组患者麻醉诱导后5、10、15分钟的呼吸动力学指标,观察两组术后并发症情况以及麻醉苏醒时间,并采取本院自制满意度调查问卷,调查患者对治疗方法及效果的满意程度。结果气管插管组插管后和拔管前后的MAP、HR水平相比于喉罩组均明显升高,组间比较差异有统计学意义(P<0.05);气管插管组PIP、Pplateau、Pmean指标相比于喉罩组均明显升高,差异有统计学意义(P<0.05);TI组麻醉苏醒期间伤口渗血、呛咳及躁动的发生率高于FRLMA组,术毕苏醒时间大于FRLMA组,差异有统计学意义(均P<0.05);喉罩组患者对治疗方法及效果的总满意率为96.67%,气管插管组为83.33%,喉罩组总满意率显著高于气管插管组(P<0.05),差异具有统计学意义。结论使用加强型喉罩行眼科手术,有利于维持血流动力学和呼吸动力学的稳定,减少术后的伤口渗血、呛咳和躁动,同时减少了术后苏醒的时间,具有较高临床应用以及推广价值。

Effect of enhanced laryngeal mask and endotracheal tube on intraoperative hemodynamic,respiratory mechanics and postoperative recovery in eye surgery

Objective To study the effect of enhanced laryngeal mask and endotracheal tube on intraoperative hemodynamic,respiratory mechanics and postoperative recovery in eye surgery.Methods 60 patients with eye surgery under general anesthesia(ASA)were divided into endotracheal tube group(30cases)and laryngeal mask group(30cases).The hemodynamic parameters and breath dynamics indexes at 5min,10 min and 15 min after anesthesia induction were observed.The postoperative complications,anesthesia wake up time,effect of satisfaction by satisfaction questionnaire were measured.Results MAP,HR,PIP,Pplateau and Pmean of endotracheal tube group were higher than that of laryngeal mask group(P<0.05).The wound bleeding,choke to cough,and the incidence of agitation of endotracheal tube group were higher than that of laryngeal mask group(P<0.05).The rate of effect of satisfaction of endotracheal tube group and laryngeal mask group were 83.33%and 96.67%.Conclusion The laryngeal mask on eye surgery is beneficial to maintain the stability of hemodynamic and respiratory dynamics,reduce postoperative wound bleeding,choking cough and agitation and reduce the postoperative time of awakening.