LMA喉罩和气管内全麻复合连续硬膜外麻醉方法应用在腹腔镜胆囊切除术中的临床分析

潘志豪　杨彤

[摘要] 目的 探討LMA喉罩和气管内全麻复合连续硬膜外麻醉方法应用在腹腔镜胆囊切除术中的临床效果。方法 2015年1月—2017年12月方便选择该院收治的98例行腹腔镜胆囊切除术治疗患者作为研究对象，利用简单随机法分为对照组和观察组，每组患者49例，对照组应用气管内全麻复合连续硬膜外麻醉方法，观察组应用LMA喉罩复合连续硬膜外麻醉方法，观察对比两组患者血流动力学各项指标稳定情况和苏醒状况。结果 观察组患者拔管（喉罩）前即刻观察组MAP和HR分别为（91.32±4.25）mmHg、（73.44±4.07）次/min，均低于对照组（105.35±3.24）mmHg、（83.44±3.15）次/min，拔管（喉罩）后即刻观察组MAP和HR分别为（92.41±3.92）mmHg、（72.44±3.85）次/min，均低于对照组（118.23±3.82）mmHg、（88.95±3.72）次/min（P<0.05），但两个时刻两组患者SpO2差异无统计学意义（P>0.05）；相较于对照组，观察组患者拔管（喉罩）时间较短，苏醒时间较早（P<0.05）。 结论 在腹腔镜胆囊切除术治疗过程中，LMA喉罩复合连续硬膜外麻醉方法效果理想，值得广泛推广。

[关键词] LMA喉罩；连续硬膜外麻醉；气管内全麻；腹腔镜胆囊切除术

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0053-03

Clinical Analysis of LMA Laryngeal Mask， Endotracheal General Anesthesia Combined with Continuous Epidural Anesthesia in the Laparoscopic Cholecystectomy

PAN Zhi-hao， YANG Tong

Department of Anesthesia， PLA 107 Hospital， Yantai， Shandong Province， 264002 China

[Abstract] Objective To study the clinical effect of LMA laryngeal mask， endotracheal general anesthesia combined with continuous epidural anesthesia in the laparoscopic cholecystectomy. Methods 98 cases of patients with laparoscopic cholecystectomy treated in our hospital from January 2015 to December 2017 were selected and randomly divided into two groups with 49 cases in each， the control group applied the endotracheal general anesthesia combined with continuous epidural anesthesia， while the observation group used the LMA laryngeal mask combined with continuous epidural anesthesia， and the steady condition and awakening status of various indexes of hemodynamics were compared between the two groups. Results The MAP and HR in the observation group before tube drawing （laryngeal mask） were lower than those in the control group， [（91.32±4.25）mmHg， （73.44±4.07）beats/min vs （105.35±3.24） mmHg， （83.44±3.15）beats/min]， and the MAP and HR in the observation group after tube drawing （laryngeal mask） were lower than those in the control group[（92.41±3.92）mmHg， （72.44±3.85）beats/min vs （118.23±3.82）mmHg， （88.95±3.72）beats/min]（P<0.05）， and the difference in the SpO2 between the two groups was not obvious（P>0.05）， and the tube drawing time （laryngeal mask） in the observation group was shorter， and the awakening time was earlier（P<0.05）. Conclusion The effect of LMA laryngeal mask combined with continuous epidural anesthesia in the laparoscopic cholecystectomy is ideal， which is worth wide promotion.

[Key words]LMA laryngeal mask； Continuous epidural anesthesia； Endotracheal general anesthesia； Laparoscopic cholecystectomy

腹腔镜胆囊切除术对麻醉方法要求较高，必须制定完善的镇痛措施，保证呼吸循环顺畅、患者苏醒时间较短且具备良好的肌松状况，降低牵拉痛等情况发生率[1-2]。该次研究基于上述背景，该次研究于2015年1月—2017年12月方便选择该院收治的98例行腹腔镜胆囊切除术治疗患者作为研究对象，探讨了LMA喉罩和气管内全麻复合连续硬膜外麻醉方法应用在腹腔镜胆囊切除术中的临床效果，现报道如下。

1 资料与方法

1.1 一般资料

方便选择该院收治的98例行腹腔镜胆囊切除术治疗患者作为研究对象，利用简单随机法分为对照组和观察组，每组患者49例；观察组男21例，女28例，年龄24～55岁，平均（37.74±3.31）岁，BMI 19.34～23.03 kg/m2，平均（21.35±0.26）kg/m2，ASAⅠ～Ⅱ级41例，Ⅲ级8例；……