喉罩替換氣管導(dǎo)管在高血壓患者經(jīng)皮腎鏡碎石手術(shù)圍拔管期的效果觀察

　　[摘要] 目的 評價術(shù)畢喉罩替換氣管導(dǎo)管在高血壓患者經(jīng)皮腎鏡下碎石手術(shù)圍拔管期間的運用效果。方法 觀察2016年1月～2017年5月于我院擇期行經(jīng)皮腎鏡下碎石手術(shù)合并高血壓病患者40例，采用隨機數(shù)字表法分為兩組（n=20）：術(shù)畢將氣管導(dǎo)管更換為喉罩組（LMA組）和未更換組（ETT組）。記錄麻醉誘導(dǎo)前（T0）、術(shù)畢（T1）、拔管前（或喉罩）即刻（T2）、拔管（或喉罩）后即刻（T3）和拔管（或喉罩）后30 min（ T4）的血壓、心率。記錄蘇醒期降壓藥使用情況。記錄麻醉蘇醒期間嗆咳、惡心、嘔吐、蘇醒延遲和拔管（或喉罩）后咽痛、聲音嘶啞等不良反應(yīng)的發(fā)生。取T1和T3時的靜脈血測血漿腎上腺素、去甲腎上腺素和皮質(zhì)醇濃度。 結(jié)果 與ETT組比較，LMA組T2、T3和T4時間點血壓和心率變化較�。≒<0.05），麻醉蘇醒期使用降壓藥的患者較少（P<0.05），嗆咳、咽痛和惡心發(fā)生等不良反應(yīng)發(fā)生率較少（P<0.05），LMA組T1和T3時血漿腎上腺素、去甲腎上腺素和皮質(zhì)醇濃度較低（P<0.05）。 結(jié)論 喉罩替換氣管導(dǎo)管在高血壓患者經(jīng)皮腎鏡碎石手術(shù)圍拔管期間的運用可明顯降低拔管反應(yīng)。
　　[關(guān)鍵詞] 喉罩；高血壓；圍拔管期；經(jīng)皮腎鏡
　　[中圖分類號] R614 [文獻標識碼] B [文章編號] 1673-9701（2018）08-0112-04
　　Effect observation of laryngeal mask replacing the endotracheal tube hypertensive patients with percutaneous nephroscope lithotripsy operation during tracheal extubation period
　　LI Ping JIANG Ren QI Yong LI Hong HE Weiyi LI Qianjun CHEN Telei CHEN Wei
　　Department of Anesthesia，Ningbo Yinzhou NO.2 Hospital，Ningbo 315100，China
　　[Abstract] Objective To evaluate effect of laryngeal mask replacing endotracheal tube after surgery in hypertensive patients with percutaneous nephroscope lithotripsy operation during tracheal extubation period. Methods 40 hypertensive patients with percutaneous nephroscope lithotripsy operation between January 2016 and May 2017 in Zhejiang NingBo Yinzhou NO.2 Hospital， using the random number table method were divided into two groups（n=20）：laryngeal mask replacing the endotracheal tube after surgery group（LMA） and not replaced group （ETT）. Record before anesthesia induction（T0）， after sugery（T1）， immediately before extubation （or laryngeal mask） （T2）， or laryngeal mask immediately after extubation （T3） and tube drawing （or laryngeal mask） after 30 mins（T4）， blood pressure and heart rate. Record whether using antihypertensive drug during anesthesia recovery period. Record the occurrence of adverse reactions such as bucking， nausea， vomiting， delayed recovery， sore throat， and voice hoarse during anesthesia recovery period. To measure the venous blood plasma epinephrine， norepinephrine and cortisol levels at the time of T1 and T3. Results Compared with ETT group， the LMA group at T2， T3， and T4 time blood pressure and heart rate changed smaller （P<0.05）， less antihypertensive drug was used in patients （P<0.05）， less adverse reaction occurred such as choking cough， sore throat and nausea（P<0.05）， the LMA group plasma epinephrine， norepinephrine， and cortisol concentration were lower at the time of T1 and T3（P<0.05）. Conclusion Laryngeal mask replacing endotracheal tube in hypertensive patients with percutaneous nephroscope lithotripsy operation can obviously reduce the extubation reaction.

相關(guān)熱詞搜索：導(dǎo)管 碎石 氣管 替換 高血壓患者