谢国强?欧银强?邓淑娴

[摘要] 目的 對比喉罩静脉全麻与气管插管静脉全麻在小儿短小手术麻醉中的效果。 方法 选取我院在2016年1月～2017年4月收治的择期行全麻短小手术的患儿86例，按照随机数字表法分为喉罩组全麻与气管插管全麻组，各43例，喉罩组采用喉罩静脉麻醉方式，插管组采用气管插管静脉麻醉方式，比较两组患者麻醉诱导前（S1）、插管或喉罩置入时（S2）、拔除气管插管或喉罩即刻（S3）的平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2），观察两组患者麻醉效果及并发症情况。 结果 （1）S1时间点喉罩组MAP、HR、SPO2指标与插管组比较差异无统计学意义（P>0.05），S2、S3时间点喉罩组MAP、HR指标明显优于插管组，差异具有统计学意义（P<0.05）；（2）喉罩组睫毛反射消失时间、拔管时间、苏醒时间与插管组比较差异无统计学意义（P>0.05）；（3）喉罩组并发症发生率为9.30%（4/43），插管组并发症发生率为27.91%（12/43），比较差异具有统计学意义（P<0.05）。 结论 喉罩静脉全麻在小儿短小手术中麻醉效果可靠，对患儿血流动力学影响较小，安全性高，值得临床推广。

[关键词] 喉罩全麻；插管全麻；小儿手术；效果对比

[中图分类号] R614 [文献标识码] A [文章编号] 2095-0616（2017）16-103-04

Comparative study of laryngeal mask vein anesthesia and intubation intravenous anesthesia in children undergoing short operation anesthesia

XIE Guoqiang OU Yinqiang DENG Shuxian

Department of Anesthesiology， Sihui Peoples Hospital， Guangdong， Sihui 526200， China

[Abstract] Objective To compare the effect of laryngeal mask vein anesthesia and intubation intravenous anesthesia in children undergoing short operation anesthesia. Methods 86 children undergoing minor general anesthesia in our hospital from January 2016 to April 2017 were selected and divided into laryngeal mask general anesthesia group and tracheal intubation general anesthesia group according to random digital table method with 43 cases in each. Patients in laryngeal mask general anesthesia group were treated with laryngeal mask vein anesthesia， and patients in tracheal intubation general anesthesia group were treated with tracheal intubation， intravenous anesthesia. Before induction of anesthesia （S1）， intubation or laryngeal mask insertion （S2） and tracheal intubation or laryngeal mask immediately （S3） mean arterial pressure （MAP）， heart rate （HR）， oxygen saturation （SpO2）， to observe the effect and complications of anesthesia in two groups of patients of the two groups were compared. Results （1） There were no statistically significant differences in MAP， HR and SPO2 between the S1 time point laryngeal mask group and the intubation group （P>0.05）. The S2 and S3 time points， laryngeal mask group， MAP and HR indexes were significantly better than those in the intubation group， the difference was statistically significant （P<0.05）. （2） There was no significant difference in the time of eyelash reflex disappearance， extubation time and recovery time between the laryngeal mask group and the intubation group （P>0.05）. （3） The complication rate of laryngeal mask group was 9.30% （4/43）， and the complication rate of intubation group was 27.91% （12/43）， the difference was statistically significant （P<0.05）. Conclusion The effect of anesthesia with covered vein anesthesia in pediatric short operation is reliable. The hemodynamics of the children is less affected and the safety is high. It is worthy of clinical promotion.endprint

[Key words] Laryngeal mask airway anesthesia； Intubation anesthesia； Pediatric surgery； Effect comparison

儿童由于生理特性较为特殊，身体处于生长发育阶段，手术中需要选择安全性高的麻醉方式，且因儿童自制力较差，对疼痛反应敏感，配合度低，对麻醉方式提出了更高的要求[1]。目前临床上用于全麻的方式为气管插管静脉麻醉，但有报道显示[2]，由于患儿内分泌系统敏感性较高，插管可刺激患儿机体出现心率增快、血压升高等血流动力学波动，通气效果不理想。近年来，喉罩静脉麻醉方式在国外小儿外科已得到广泛应用[3]。喉罩主要是安置在咽喉腔，利用气囊将试管和咽喉腔封闭，通过咽喉进行通气的人工气道，其作为新兴的通气技术，大量报道表明[4-5]，其在小儿手术麻醉效果方面具有良好疗效。本研……