国际麻醉学与复苏杂志   2017, Issue (12): 9-9
    
SLIPATM喉罩与气管插管在小儿腹腔镜疝修补术 中的比较
白建云, 贺峰, 郭增林1()
1.榆林市第二医院
Comparison of the streamlined pharynx airway liner and tracheal intubation in pediatric laparoscopic hernia surgery
 全文:
摘要:

目的 观察SLIPATM喉罩在小儿腹腔镜疝修补术中应用的可行性及安全性。 方法 择期行腹腔镜疝修补术的患儿80例,年龄3~12岁,ASA分级Ⅰ、Ⅱ级,按随机数字表法分成SLIPATM喉罩组(S组)和气管插管组(T组),每组40例。记录两组麻醉诱导前(T0)、管(罩)插入前(T1)、管(罩)插入后1 min(T2)、管(罩)拔出后1 min(T3)时的HR、SBP、DBP,记录拔出气管导管或喉罩时发生呛咳、声音嘶哑、术后咽痛、吞咽困难、口腔中带血迹、喉痉挛等并发症的情况。 结果 最终纳入患者79例,S组39例,T组40例。T2、T3时S组HR、SBP、DBP低于T组。T0、T1时两组比较,HR、SBP、DBP差异无统计学意义(P>0.05)。术后拔出气管导管或喉罩时S组患儿发生呛咳5例、声音嘶哑4例,明显低于T组患儿(发生呛咳15例,声音嘶哑12例),差异有统计学意义(P<0.05)。术后咽痛、吞咽困难、口腔中带血迹、喉痉挛的发生率比较,两组差异无统计学意义(P>0.05)。 结论 SLIPATM喉罩用于小儿腹腔镜疝修补术较气管导管对小儿的血流动力学影响小、并发症低、通气满意,可安全应用于小儿腹腔镜疝修补术。

关键词: 喉罩; 气管插管; 腹腔镜治疗; 疝修补术
Abstract:

Objective To observe the feasibility and safety of the SLIPATM in pediatric laparoscopic hernia surgery. Methods Eighty pediatric patients, who were scheduled to undergo laparoscopic hernia surgery(aged 3-12 y, ASA Ⅰ or Ⅱ), were randomly divided into two groups: SLIPATM group(S group) and tracheal intubation group(T group). Each group had forty patients. HR, SBP and DBP were recorded on time points of before anesthesia induction(T0), before insertion of SLIPATM or tracheal tube(T1), 1 min after the insertion of SLIPATM or tracheal tube(T2) , and 1 min after extraction of SLIPATM or tracheal tube(T3). In addition, complications such as cough, hoarseness, pharyngalgia, dysphagia, bleeding and aryngospasm were also recorded after the extraction of SLIPATM or tracheal tube. Results There were totally seventy nine patients enrolled, including thirty nine patients in S group and forty in T group. At T2-T3, the HR, SBP, DBP of S group were significantly lower than T group(P<0.05). There was no significant statistically difference between records at T0 and T1(P>0.05). After extraction of SLIPATM or tracheal tube, five of the thirty nine patients coughed and four of the thirty nine patients had hoarse throats in S group while fifteen of the forty patients coughed and twelve of the forty patients had hoarse throats in T group. The incidences of cough and hoarseness in S group were significantly lower than the incidences happened in T group(P<0.05). However, there was no statistically difference at the incidence of complications such as pharyngalgia, dysphagia, bleeding and laryngospasm between the two groups. Conclusions SLIPATM has fewer effects on pediatric hemodynamics and lower complication incidence than the incidence of tracheal intubation. Therefore, it can be safely applied in pediatric laparoscopic hernia surgery.

Key words: Laryneal mask; Tracheal intubation; Therapeutic laparoscopy; Herniorrhaphy