喉罩輔助下SIMV模式全麻在老年人甲狀腺次全切除術(shù)中的研究

　　[摘要]目的 探討喉罩輔助下同步間歇指令通氣（SIMV）模式全麻應(yīng)用在老年人甲狀腺次全切除術(shù)的效果及安全性。方法 選取2015年4月～2016年4月我院收治的年齡≥65歲、ASA Ⅰ～Ⅲ級且行甲狀腺次全切除術(shù)的60例患者作為研究對象，隨機分為實驗組和對照組，各30例。實驗組行喉罩輔助下SIMV模式全麻手術(shù)，對照組采取傳統(tǒng)氣管插管全麻手術(shù)，觀察兩組麻醉前后血流動力學(xué)、呼吸功能恢復(fù)及麻醉相關(guān)并發(fā)癥發(fā)生情況。結(jié)果 兩組T1～T3時的SBP、DBP和HR水平與T0時比較，差異有統(tǒng)計學(xué)意義（P<0.05）。實驗組T1～T2時的SBP、DBP和HR水平高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。實驗組的麻醉用藥量少于對照組，首次拔管時間和出室時間均短于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。實驗組的麻醉相關(guān)并發(fā)癥發(fā)生率為6.67%，低于對照組的26.67%，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 喉罩輔助下SIMV模式全麻更利于維持老年甲狀腺次全切除術(shù)中的血流動力學(xué)穩(wěn)定，縮短蘇醒時間，且并發(fā)癥少，具有較好的應(yīng)用價值。
　　[關(guān)鍵詞]喉罩；同步間歇指令通氣；甲狀腺次全切除；全麻；研究
　　[中圖分類號] R614.2 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-4721（2018）2（b）-0107-03
　　Study of SIMV mode in general anesthesia assisted by laryngeal mask in the subtotal thyroidectomy for the elderly
　　YAN Kai-shu LIAO Xi-qiang ZHAO Chong-han CHEN Zhen-ai
　　Department of Anesthesiology，People′s Hospital of Xinhui District of Jiangmen City in Guangdong Province，Jiangmen 529100，China
　　[Abstract]Objective To explore the efficacy and safety of laryngeal mask assisted synchronous intermittent mandatory ventilation （SIMV） mode in general anesthesia for elderly patients undergoing subtotal thyroidectomy.Methods A total of 60 patients who were no less than 65 years old in ASA Ⅰ-Ⅲ grade with subtotal resection from April 2015 to April 2016 were selected as research objects.They were evenly divided into the experimental group and the control group by a random and double blind method.In the experimental group，laryngeal mask assisted SIMV mode in general anesthesia was implemented，while in the control group，conventional tracheal intubation anesthesia was adopted.The hemodynamics before and after anesthesia，respiratory function recovery，and anesthesia related complications were observed between the two groups.Results Compared the level of systolic blood pressure （SBP），diastolic blood pressure （DBP），and heart rate （HR） at T0 in the two groups，there was significant difference in the two groups from T1 to T3 （P<0.05）.In the experimental group，the level of SBP，DBP，and HR from T1 to T2 were higher compared with those in the control group，with statistical differences （P<0.05）.The dose of anesthesia in the experimental group was lower than those in the control group，the first extubation time，and time to leave operation room in the experimental group was shorter than those in the control group，which were displayed statistical differences （P<0.05）.The incidence of anesthesia-related complications in the experimental group was 6.67%，which was lower than that in the control group accounting for 26.67%，with a statistical difference （P<0.05）.Conclusion Laryngeal mask assisted SIMV mode in general anesthesia is beneficial to maintain the hemodynamic stabilityin elderly patients undergoing subtotal thyroidectomy，and shorten awakening time with few complications，which has a better application value.

相關(guān)熱詞搜索：全麻 甲狀腺 老年人 切除術(shù) 輔助