苏孟勤　钟巍　任苏恩

【摘要】 目的：分析在心血管内科介入手术过程中给予喉罩麻醉的临床效果。方法：选取本院2013年1月-2015年6月期间收治的心血管内科介入手术患儿52例作为研究对象，按照不同麻醉方法分为试验组和对照组，每组各26例，其中试验组行喉罩麻醉，对照组行气管插管麻醉。分别观察两组患儿的血流动力学指标，比较拔管时间及清醒时间和苏醒期不良反应发生情况。结果：试验组患儿在麻醉后的不同时刻（T2、T3、T4时刻）的心率（HR）与平均动脉压（MAP）均明显低于对照组，差异均有统计学意义（P<0.05）。试验组的拔管时间与清醒时间均明显短于对照组，差异均有统计学意义（P<0.01）。试验组苏醒期出现躁动、咽痛、喉痉挛等不良反应的发生率为11.5%，明显低于对照组的38.5%，差异有统计学意义（P<0.05）。结论：心血管内科疾病患者在行介入手术中，采用喉罩麻醉具有良好的效果。与传统气管插管相比，其具有稳定血流动力学、缩短清醒时间、降低苏醒期不良反应发生率等优点，值得临床推广使用。

【关键词】 心血管内科； 介入手术； 喉罩； 麻醉效果； 血流动力学

【Abstract】 Objective：To analyze the clinical effect of laryngeal mask in the anesthesia of interventional surgery of cardiovascular internal medicine.Method：52 children with interventional surgery in cardiovascular internal medicine were selected in our hospital from January 2013 to June 2015，and they were divided into the experimental group and the control group according to the different anesthesia methods，26 cases in each group.The experimental group was given laryngeal mask anesthesia，the control group was given tracheal intubation.The hemodynamic indexes， extubation time，waking time and adverse reactions in recovery phase between the two groups were observed and compared.Result：The heart rate（HR），the mean arterial pressure（MAP） of the experimental group at different time after anesthesia（at T2，T3，T4 time） were significantly lower than those of the control group，the differences were statistically significant（P<0.05）.The extubation time and waking time of the experimental group were significantly shorter than the control group，the differences were statistically significant（P<0.01）.The incidence of adverse reactions（restlessness，sore throat，laryngeal spasm） in the experimental group was 11.5%，which was significantly lower than 38.5% of the control group，the difference was statistically significant（P<0.05）.Conclusion：In cardiovascular internal medicine disease patients with interventional operation，using a laryngeal mask for anesthesia has a good effect.Compared with endotracheal intubation，it has the advantages of stabilize hemodynamics，shorten the waking time and reduce the incidence of adverse reactions in the recovery phase，is worthy of clinical popularization and application.

【Key words】 Cardiovascular internal medicine； Interventional surgery； Laryngeal mask； Anesthesia effect； Hemodynamic

First-authors address：The Chest Hospital of Henan Province，Zhengzhou 450052，China

doi：10.3969/j.issn.1674-4985.2016.05.013

心血管内科手术患者的麻醉，对肌肉松弛程度没有特殊要求，但需要患者处于良好的麻醉状态，且术后能够在短时间内清醒，这就对麻醉医师的工作提出了挑战[1]。喉罩作为一种通气形式，介于气管插管和面罩之间，由于具有操作简单、不良反应少、患者耐受性高等优点，在临床上被广泛应用[2]。本研究选取本院收治的心脏内科疾病手术患儿进行分析，以期探讨喉罩麻醉的临床应用价值，现报道如下。

1 资料与方法

1.1 一般资料 选取本院2013年1月-2015年6月收治的心血管内科介入手术患儿52例作为研究对象，按照不同麻醉方法将其分为试验组和对照组，每组26例。纳入标准：（1）根据《各类心血管疾病诊断要点》[3]，患儿经临床检查、影像学检查后确诊；（2）患儿资料完整、符合手术指征；（3）本研究经本院医学伦理委员会审批，所有患者或家属均签署书面知情同意书。……