【摘要】 目的 评价喉罩通气全麻应用于脑血管动脉瘤介入栓塞治疗的可行性和安全性，并与气管插管全麻作比较。方法 选择择期行颅内动脉瘤介入栓塞术患者80例,年龄 25-65岁，ASAⅠ-Ⅱ级，随机分为喉罩组(L组)和气管插管组(T组),每组 40例。记录患者诱导前、诱导后（插入气管导管或喉罩前）、插管即刻、插管后1、3 min、股动脉穿刺插管时、动脉瘤栓塞时、拔管即刻、拔管后1、3min时的平均动脉压(MAP) 、心率（HR）、脉搏血氧饱和度（SPO2）及呼气末二氧化碳分压( PETCO2 )进行比较，并观察术毕患者睁眼时间、定向力恢复时间、拔管时间以及拔管（罩）时病人是否有呛咳、躁动、恶心呕吐及术后有无咽痛、声音嘶哑等并发症发生。 结果 (1) 插管 (罩) 期和拔管 (罩) 期T组HR、MAP升高明显 ( P < 0.05) , 与L 组相比差异有显著性 ( P < 0.05) 。(2) T组手术结束患者定向力恢复时间、睁眼时间、拔管时间均明显高于L组(P < 0.05)。(3)拔管(罩)期T组体动及呛咳发生率明显高于L 组( P < 0.05) ;术后咽痛、声嘶发生率T组明显高于L 组( P < 0.05) 。（4）两组患者均无低氧血症及二氧化碳潴留发生。结论 喉罩刺激小，通气可靠，术中血流动力学平稳，术后苏醒快，定向力恢复好，较气管插管更适合应用于颅内动脉栓塞术。
【Abstract】 Objective To evaluate the security and feasibility of LAM used in intracranial aneurysm patients and compare with endotracheal intubation. Methods Eighty ASA Ⅰ-Ⅱpatients aged 22-65 years undergoing intracranial aneurysm surgery were enrolled in this study. The patients were randomized to receive either LMA ( n =40) or endotracheal intubator ( n = 40). Hemodynamic parameters were continuously monitored during anesthesia induction, operation and anesthesia recovery. The time of recovery, eyes opening and extubation were recorded. Whether coughing, restlessness, nausea and vomiting when extubion were also recorded. Results There was an obvious hemodynamic change in group T during the time of anesthesia induction and anesthesia recovery (P < 0.05 ). Comparing with group L, the incidence of body movement, coughing and sore throat is much higher (P < 0.05). No hypoxemia and Hypercapnia were noted. Conclusion LMA can prevent Cardiovascular stress response and is more suitable for intracranial aneurysm patients.
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