耿偉峰

【摘 要】 目的：婦產(chǎn)科臨床應(yīng)用喉罩全麻通氣的安全性分析。方法：選擇本院婦產(chǎn)科于2018年9月至2019年10月收治的94例患者為研究對(duì)象，按照麻醉方案的差異性劃分為研究組與對(duì)照組，每組各47例;對(duì)照組患者接受氣管內(nèi)插管通氣，而研究組患者接受喉罩全麻通氣，對(duì)比兩組患者治療前后的血流動(dòng)力學(xué)指標(biāo)以及并發(fā)癥發(fā)生率。結(jié)果：通氣前兩組患者的血流動(dòng)力學(xué)較為接近（P>0.05），而通氣后，研究組患者的舒張壓、收縮壓以及平均動(dòng)脈壓均低于對(duì)照組患者，心率則高于對(duì)照組患者，數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;此外，研究組患者并發(fā)癥發(fā)生率為4.26%，低于對(duì)照組的19.15%，數(shù)據(jù)對(duì)比，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：婦產(chǎn)科患者采用喉罩全麻通氣方式，可以提高人體血流動(dòng)力學(xué)的穩(wěn)定性，減少并發(fā)癥風(fēng)險(xiǎn)，安全性良好。

【關(guān)鍵詞】 婦產(chǎn)科;喉罩全麻;血流動(dòng)力學(xué);并發(fā)癥

[Abstract] Objective：Safety analysis of general application of laryngeal mask general anesthesia in obstetrics and gynecology. Methods： 94 patients who underwent obstetrics and gynaecology in our hospital from September 2018 to October 2019 were selected as subjects. According to the difference of anesthesia program， they were divided into experimental group and control group， 47 cases in each group. Intratracheal intubation was ventilated， and patients in the experimental group underwent general anesthesia with laryngeal mask. The hemodynamic parameters and complication rates before and after treatment were compared between the two groups. Results： The hemodynamics of the two groups before ventilation were close （P>0.05）. After ventilation， the diastolic blood pressure， hand systolic pressure and mean arterial pressure of the experimental group were lower than those of the control group， and the heart rate was higher than that of the control group. In the group of patients， the difference in data was statistically significant （P<0.05）. In addition， the incidence of complications in the experimental group was 4.26%， which was lower than that in the control group， which was 19.15%， that is， the data were compared. The difference between the groups was statistically significant （P<0.05）. Conclusion： Obstetrics and gynecology patients with laryngeal mask general anesthesia ventilation can improve the stability of human hemodynamics， reduce the risk of complications， and have good safety.

[Key words]Obstetrics and gynecology; Laryngeal mask general anesthesia; Hemodynamics; Complications

現(xiàn)階段醫(yī)療機(jī)構(gòu)婦產(chǎn)科普遍以氣管內(nèi)插管為常規(guī)通氣方案，極易導(dǎo)致患者發(fā)生應(yīng)激反應(yīng)，進(jìn)而弱化麻醉效果，此外，操作不適宜還會(huì)增加患者出現(xiàn)并發(fā)癥的風(fēng)險(xiǎn)，例如通氣不暢、喉頭水腫、鼻腔黏膜出血等等[1-2]。喉罩全麻屬于新興通氣方案，其在通氣效果、操作等方面均得到了顯著的改善[3]。本次為了驗(yàn)證喉罩全麻在婦產(chǎn)科臨床中的應(yīng)用效果，選擇本院婦產(chǎn)科于2018年9月至2019年10月收治的94例患者為研究對(duì)象，展開如下對(duì)比分析。

1 資料與方法

1.1 一般資料

選擇本院婦產(chǎn)科于2018年9月至2019年10月收治的94例患者為研究對(duì)象，所有患者均了解并同意參與本次研究，且未見合并其他臟器、系統(tǒng)性疾病;按照麻醉方案的差異性劃分為研究組與對(duì)照組，每組各47例;對(duì)照組年齡為23～47歲，平均（34.35±8.63）歲;研究組年齡為21～48歲，平均（33.64±6.41）歲。對(duì)比分析兩組患者的基線資料數(shù)據(jù)，組間差異統(tǒng)計(jì)學(xué)意義不成立（P>0.05），研究可行。

1.2 方法

兩組均接受全麻：構(gòu)建靜脈通道，取2mg/kg丙泊酚（廣東嘉博制藥有限公司，國藥準(zhǔn)字H20051842）+0.15g/kg順阿曲庫銨（浙江仙琚制藥股份有限公司，國藥準(zhǔn)字H20090202）對(duì)患者實(shí)施誘導(dǎo)麻醉，然后取5μg/kg芬太尼（國藥集團(tuán)工業(yè)有限公司廊坊分公司，國藥準(zhǔn)字H20123297）以及丙泊酚對(duì)患者進(jìn)行靜脈注射，順阿曲庫銨對(duì)患者行間斷性靜脈注射。