摘要
目的 比较喉罩（LMA）与气管插管（TT）两种气道管理方式下对上呼吸道感染患儿围手术期呼吸道不良事件的影响.方法 2006年11月至2012年10月于浙江省诸暨市人民医院实施手术合并轻中度上呼吸道感染的76例全身麻醉患儿,经医院伦理委员会审核通过,数字表法随机分为两组：Ⅰ组行气管内插管全身麻醉（TT组,n=36）,Ⅱ组采用喉罩（LMA）气道管理全身麻醉（LMA组,n=40）.观察两组患儿围手术期平均动脉压（MAP）、心率、脉搏血氧饱和度（SPO2）及呼气末二氧化碳分压（PETCO2）的变化.记录麻醉复苏期间低氧血症、烦躁、咽痛及喉痉挛等并发症发生率.评估术前和术后呼吸道感染的临床症状等.结果 两组患儿术前上呼吸道感染临床症状差异无统计学意义,均能耐受TT或LMA.但是,LMA组在置入喉罩后或拔除喉罩后即刻的血流动力学比TT组更稳定（P〈0.05）,术后低氧血症、烦躁、喉痉挛及咽喉痛发生率均明显低于TT组（P〈0.05）,且LMA组术后24 h呼吸道感染症状较TT组显著减轻（P〈0.05）.结论 喉罩气道管理方式可以降低上呼吸道感染患儿围手术期不良反应的发生率,具有良好的安全性.
Objective To investigate the effect of endotracheal intubation （Tr） or the laryngeal mask airway （LMA） on the incidence of perioperative respiratory adverse events in children with upper respiratory tract infection undergo general anesthesia. Methods From November, 2006 to October, 2012 in the Zhuji People＇s Hospital, 76 children with upper respiratory tract infection approved by hospital ethic committee were randomly divided into 2 groups ： group I （ n = 36）, children were applied with endotracheal intubation during general anesthesia （ TT group） , while group 11 （ n = 40 ） , laryngeal mask airway were used （LMA group）. Iutraoperative mean arterial pressure （MAP）, hear rate （HR）, pulse oximetry （SPO2）, and end-tidal carbon dioxide partial pressure （PET CO2 ） were recorded during the surgery. The incidence of adverse events such as hypoxemia, fidgety, sore throat, and laryngospasm were evaluated in resuscitation room. We also assessed the pre- and postoperative symptoms of respiratory tract infection. Results There was no significant difference in upper respiratory tract infection symptoms between two groups, and the children in both groups have good tolerance to TF or LMA. However, the hemodynamics status in LMA group were more stable than those in TI＇ group after the LMA insertion or removing （P 〈 0. 05）. The incidence of hypoxemia, fidgety, sore throat, and laryngospasm were significant lower in LMA group compared with those in Tr group （P 〈 0. 05 ）. Conclusion LMA could decrease the incidence of perioperative respiratory adverse events and can be safely used in children with upper respiratory tract infection undergo general anesthesia.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第45期3626-3628,共3页
National Medical Journal of China
关键词
上呼吸道感染
儿童
气管插管
喉罩
不良事件
Upper respiratory infections
Child
Endotracheal intubation
Laryngeal maskairway
Adverse effect
