喉罩与气管插管全麻在妇科腹腔镜手术中应用比较

目的：喉罩和气管插管全麻均可应用于妇科腹腔镜手术，观察两者对患者血流动力学及并发症的影响，探讨两种通气方式的有效性和安全性。方法：选择40例择期妇科腹腔镜手术患者随机分为喉罩组（L组）和气管插管组（T组）各20例，比较两组麻醉期间血流动力学变化，并记录两组拔管期的不良反应及术后并发症等。结果：L组在喉罩置入和拔出后的HR、MAP无明显变化（P〉0.05）。T组插管后即刻拔管后即刻HR、MAP均显著升高（P〈0.05）。两组呼气末二氧化碳（PETCO2）、气道峰压（Ppeak）、气道平均压（Pmean）随气腹的影响变化一致，组间比较无统计学意义（P〉0.05）。拔管期间L组发生的体动、呛咳较T组明显减少，差异有统计学意义（P〈0.05）；L组术后咽痛发生率显著低于T组（P〈0.05）。结论：在全麻妇科腹腔镜手术中喉罩可达到与气管插管一样满意的通气效果，易于维持血流动力学稳定，且全麻后恢复平稳。

The laryngeal mask with endotracheal intubation anesthesia used in gynecological laparoscopic surgery application

Objective：Laryngeal mask airway and endotracheal intubation anesthesia can be used in gynecological laparoscopic operation, to observe the effects of both on hemodynamics and complications, efficacy and safety of two kinds of ventilation mode. Methods：40 cases of patients undergoing gynecological laparoscopic operation were ran-domly divided into laryngeal mask group （group L） and endotracheal intubation group （group T） 20 cases, compared two groups of anesthesia on hemodynamics during induction, and record the adverse reactions and the two groups in complications after extubation. Results：in L group the mask and after removal of HR in the throat, no significant change in MAP（P〉0.05）. T intubation group immediately after extubation HR, MAP were significantly increased （ P〈0.05）. Two groups of end tidal carbon dioxide （P ETCO2）,peak airway pressure （Ppeak）, mean airway pressure （Pmean） consistent with pneumoperitoneum changes, no statistical significance between the two groups （ P〉0.05）. L group oc-curred during extubation of body movement, cough decreased obviously compared with T group, the difference was statistically significant （P〈0.05） angina occurred after operation in L group was significantly lower than that in T group （P〈0.05）. Conclusion：in general anesthesia in gynecological laparoscopic operation can achieve the effect of laryngeal mask ventilation and tracheal intubation as satisfactory, easy to maintain the stability of hemodynamics, and recovered smoothly after general anesthesia.