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目的观察双管喉罩用于全身麻醉腔镜乳腺癌根治术的临床效果。方法全身麻醉下行腔镜乳腺癌根治术患者40例,ASAⅠ或Ⅱ级,随机分为双管喉罩组(P组)和气管导管组(T组),每组20例。比较两组血流动力学指标,观察并记录CO2充气前和充气后15、30、60 min时的动脉血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)及气道峰压(Ppeak);观察并记录拔除喉罩(气管导管)时的不良反应和术后并发症。结果与T组比较,P组插入喉罩(气管导管)即刻(T1)、插入喉罩(气管导管)后2 min(T2)、拔除喉罩(气管导管)即刻(T4)、拔除喉罩(气管导管)后2 min(T5)时心率(HR)、收缩压(SBP)、舒张压(DBP)较低(P<0.05);与插入喉罩(气管导管)前(T0)时比较,T组T1、T2时HR、SBP、DBP较高(P<0.05);与拔除喉罩(气管导管)前(T3)时比较,T组T4、T5时HR、SBP、DBP较高(P<0.05)。两组间CO2充气前后各时间点SpO2、PETCO2及Ppeak比较差异无统计学意义(P>0.05)。与T组比较,P组呛咳、咽痛等不良反应发生率较低(P<0.05)。结论双管喉罩通气全身麻醉可安全有效用于腔镜乳腺癌根治术,对血流动力学影响小,不良反应少。
Objective To observe the clinical effect of double-tube laryngeal mask for general anesthesia endoscopic radical mastectomy. Methods Forty ASA Ⅰ or Ⅱ patients undergoing endoscopic radical mastectomy under general anesthesia were randomly divided into two groups: laryngeal mask group (group P) and endotracheal tube group (group T), with 20 cases in each group. The hemodynamic parameters of the two groups were compared and the arterial oxygen saturation (SpO2), end-expiratory carbon dioxide partial pressure (PETCO2) and peak airway pressure before and after inflation Ppeak); Observe and record the adverse reactions and postoperative complications of laryngeal mask (tracheal tube) removal. Results Compared with group T, the laryngeal mask (endotracheal tube) was inserted immediately (T1), the laryngeal mask (endotracheal tube) was inserted for 2 minutes (T2), the laryngeal mask (endotracheal tube) was removed immediately (T4) (P <0.05). The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower at 2 months after tracheal tube (T5) The HR, SBP and DBP were higher in group T at T1 and T2 (P <0.05), but higher at T4 and T5 in T group (P <0.05) than those before laryngeal mask (tracheal tube) ). There were no significant differences in SpO2, PETCO2 and Ppeak between the two groups before and after CO2 aeration (P> 0.05). Compared with T group, P group cough, sore throat and other adverse reactions were lower (P <0.05). Conclusion Two-tube laryngeal mask ventilation for general anesthesia can be safely and effectively used for laparoscopic radical mastectomy, with little effect on hemodynamics and few adverse reactions.