一次性喉罩用于腹腔镜胆囊切除术的临床研究

目的探讨在腹腔镜胆囊切除术（LC）全麻中一次性喉罩替代气管导管的安全性和可行性。方法择期行LC患者122例随机分为气管插管组（61例）和喉罩组（61例1。记录操作一次成功率、操作时间、气道密封压及麻醉前、气管插管或喉罩置入前后、拔除气管导管或喉罩后BP、HR、SpO2；记录气腹前后气道峰压（Ppeak）、肺顺应性（Compl）、呼吸末二氧化碳分压（PetCO2）及术中血气结果；并对喉罩组拔出喉罩后通气罩远端分泌物进行pH值试纸测试。结果两组患者术中及术后SpO2均维持98％以上，通气参数PetCO2及术中血气PaCO2均在正常范围内，两组比较无显著性差异。喉罩组在置入、拔除过程中，血流动力学参数稳定，而插管组气管插管及拔管过程中，收缩压分别为（145．05±22．82）mmHg、（145．17±14．22）mmHg，舒张压分别为（88．13±14．65）mmHg、（87．27±10．37）mmHg，心率分别为（86．00±14．65）次，分、（92±10．96）次／分，与喉罩组比较P均〈0．05。喉罩组在苏醒期并发症明显小于气管插管组（P〈0．05）。喉罩组拔罩后充气罩远端分泌物pH值均在7．0～8．0。结论一次性喉罩全麻正压通气可用于LC患者：其安全性仍有待大样本研究。

Clinical research for the application of disposable-laryngeal mask airway in laparoscopic cholecystectomy

Objective To investigate the feasibility and safety of the Disposable-laryngeal mask airway (D-LMA) as an alternative to the endotracheal intubation (ETT) under general anesthesia during laparoscopic cholecystectomy(LC). Methods 122 patients with LC were randomized divided into the D-LMA group (61) and the ETT group (61). The times, duration of intubation and airway seal pressure were recorded. The BP, HR, SpO2 were read out before anesthesia, before and after tracheal intubation or laryngeal mask insertion...