喉罩通气全麻在高血压患者腹腔镜胆囊切除术中的临床观察

目的：观察高血压病人腹腔镜胆囊切除术中应用喉罩通气全麻时，对患者血压和心率的影响。方法：高血压腹腔镜胆囊切除术患者100例，ASAI～Ⅱ级，随机分为喉罩组和气管插管组每组50例。记录麻醉前、诱导时、置人喉罩／插管时、胆囊切除时、拨喉罩或拔管时5个时间点的HR、MAP，并进行组间比较。结果：气管插管组于插管时、拔管时均较麻醉前、诱导时及喉罩组HR明显增快、MAP明显升高；诱导时喉罩组较气管插管组MAP明显升高；胆囊切除时喉罩组较置喉罩或插管时HR明显减慢、MAP明显降低；拨喉罩或拔管时较胆囊切除时HR明显增快、MAP明显升高。结论：喉罩通气全麻在高血压病人腹腔镜胆囊切除术中可有效预防心血管应激反应，避免血压和心率的剧烈波动。

Clinical observation of general anesthesia of laryngeal mask airway on patients with hypertension in laparoscopic cholecystecomy

Objective：To observe the influence on BP and HR of patients with hypertension in laparescopic choleeysteeomy （LC） by using general anesthesia of laryngeal mask airway （LMA）. Methods ：100 essential hypertension patients （ ASA I or II class） under LC were allocated rando - rely to either LMA group （ n = 50 ） or endotracheal intubation （ ETT ） group （ n = 50） with mechanical ventilation. HR and mean arterial pressure（MAP） were recorded before anaesthesia, induce, put into LMA/ETr immediately , cholecysectomy , extubation immediately ,and done group compa - fison. Results： ttR and MAP in ETT group were significantly quicker or higher at the intubati - on,the extubation than the induction,and before anesthesia. MAP at the induction in LMA group were singnificantly higher than ETT group. HR at cholecysectomy in LMA group and ETT group were slower than the induction or put laryngeal mask. HR and MAP at the extubation or the extu- bated laryngeal mask in ETT group and LMA group were singnificantly quicker or higher. Conclusion ： General anesthesia of LMA can prevents hemodynamic effects and avoid the violent motion of blood pressure and HR in LC.