喉罩辅助下SIMV模式全麻在老年人甲状腺次全切除术中的研究

　　[摘要]目的 探討喉罩辅助下同步间歇指令通气（SIMV）模式全麻应用在老年人甲状腺次全切除术的效果及安全性。方法 选取2015年4月～2016年4月我院收治的年龄≥65岁、ASA Ⅰ～Ⅲ级且行甲状腺次全切除术的60例患者作为研究对象，随机分为实验组和对照组，各30例。实验组行喉罩辅助下SIMV模式全麻手术，对照组采取传统气管插管全麻手术，观察两组麻醉前后血流动力学、呼吸功能恢复及麻醉相关并发症发生情况。结果 两组T1～T3时的SBP、DBP和HR水平与T0时比较，差异有统计学意义（P<0.05）。实验组T1～T2时的SBP、DBP和HR水平高于对照组，差异有统计学意义（P<0.05）。实验组的麻醉用药量少于对照组，首次拔管时间和出室时间均短于对照组，差异有统计学意义（P<0.05）。实验组的麻醉相关并发症发生率为6.67%，低于对照组的26.67%，差异有统计学意义（P<0.05）。结论 喉罩辅助下SIMV模式全麻更利于维持老年甲状腺次全切除术中的血流动力学稳定，缩短苏醒时间，且并发症少，具有较好的应用价值。
　　[关键词]喉罩；同步间歇指令通气；甲状腺次全切除；全麻；研究
　　[中图分类号] R614.2 [文献标识码] A [文章编号] 1674-4721（2018）2（b）-0107-03
　　Study of SIMV mode in general anesthesia assisted by laryngeal mask in the subtotal thyroidectomy for the elderly
　　YAN Kai-shu LIAO Xi-qiang ZHAO Chong-han CHEN Zhen-ai
　　Department of Anesthesiology，People′s Hospital of Xinhui District of Jiangmen City in Guangdong Province，Jiangmen 529100，China
　　[Abstract]Objective To explore the efficacy and safety of laryngeal mask assisted synchronous intermittent mandatory ventilation （SIMV） mode in general anesthesia for elderly patients undergoing subtotal thyroidectomy.Methods A total of 60 patients who were no less than 65 years old in ASA Ⅰ-Ⅲ grade with subtotal resection from April 2015 to April 2016 were selected as research objects.They were evenly divided into the experimental group and the control group by a random and double blind method.In the experimental group，laryngeal mask assisted SIMV mode in general anesthesia was implemented，while in the control group，conventional tracheal intubation anesthesia was adopted.The hemodynamics before and after anesthesia，respiratory function recovery，and anesthesia related complications were observed between the two groups.Results Compared the level of systolic blood pressure （SBP），diastolic blood pressure （DBP），and heart rate （HR） at T0 in the two groups，there was significant difference in the two groups from T1 to T3 （P<0.05）.In the experimental group，the level of SBP，DBP，and HR from T1 to T2 were higher compared with those in the control group，with statistical differences （P<0.05）.The dose of anesthesia in the experimental group was lower than those in the control group，the first extubation time，and time to leave operation room in the experimental group was shorter than those in the control group，which were displayed statistical differences （P<0.05）.The incidence of anesthesia-related complications in the experimental group was 6.67%，which was lower than that in the control group accounting for 26.67%，with a statistical difference （P<0.05）.Conclusion Laryngeal mask assisted SIMV mode in general anesthesia is beneficial to maintain the hemodynamic stabilityin elderly patients undergoing subtotal thyroidectomy，and shorten awakening time with few complications，which has a better application value.

相关热词搜索：全麻 甲状腺 老年人 切除术 辅助