slipa喉罩用于全身麻醉下小儿保留自主呼吸的可行性和安全性.docVIP

SLIPA喉罩用于全身麻醉下小儿保留自主呼吸的可行性和安全性 　　【摘要】 目的：探?SLIPA喉罩在全身麻醉下小儿术中保留自主呼吸的可行性和安全性。方法：将本院在SLIPA喉罩全身麻醉下手术治疗的患儿按照随机数字飙风分为保留自主呼吸组和机械通气组，记录喉罩置入即刻、置入后10、30、60 min的心率、MAP、PaO2、PaCO2、PETCO2、pH值、肺泡-动脉氧分压差、呼吸指数等指标变化。结果：保留自主呼吸组患儿在各时间点心率、MAP、PaO2比较，差异均无统计学意义（P0.05），置入后10、30、60 min PaCO2、PETCO2均较喉罩置入即刻明显升高，pH值明显降低，差异均有统计学意义（P0.05）。两组患儿各时间点心率、MAP、PaO2比较，差异均无统计学意义（P0.05），保留自主呼吸组患儿置入后10、30、60 min PaCO2、PETCO2明显高于机械通气组，pH值明显低于机械通气组，差异均有统计学意义（P0.05）。结论：SLIPA喉罩用于全身麻醉下小儿保留自主呼吸是安全可行的，但全麻中要对PaCO2、PETCO2及pH值进行严密监测，并对CO2蓄积所致高碳酸血症引起足够的重视。 　　【关键词】 喉罩； 麻醉； 自主呼吸； 机械通气 　　Feasibility and Safety of SLIPA Laryngeal Mask for Pediatric Retaining Spontaneous Respiration under General Anesthesia/ZENG Hui-jing，WANG Wei.//Medical Innovation of China，2016，13（35）：031-034 　　【Abstact】 Objective：To investigate the feasibility and safety of SLIPA laryngeal mask for pediatric retaining spontaneous respiration under the general anesthesia.Method：The children who were operated under the SLIPA laryngeal mask general anesthesia of our hospital were randomly divided into retaining spontaneous respiration group and mechanical ventilation group，recorded the change of heart rate，MAP，PaO2，PaCO2，PETCO2，pH，alveolar-arterial oxygen tension difference， respiratory index in laryngeal mask insertion instant，10，30，60 min after insertion.Result：The difference of heart rate，MAP，PaO2 of retaining spontaneous respiration group children at different time points had no statistical significance（P0.05），PaCO2，PETCO2 values at 10，30，60 min after insertion were higher than the laryngeal mask insertion instant，and pH value was decreased obviously，the differences had statistical significance（P0.05）.Heart rate，MAP，PaO2 values at different time points of two groups had no statistical significance（P0.05），PaCO2，PETCO2 values at 10，30，60 min after insertion of retaining spontaneous respiration group children were significantly higher than those of the mechanical ventilation group，pH value was lower than that of the mechanical ventilation group，t