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目的:对照研究喉罩与气管插管全凭七氟醚吸入麻醉用于小儿眼科短小手术的优缺点。方法:选取2012年1月至2013年12月于我院行行眼科手术的ASAⅠ~Ⅱ级小儿共80例,随机分为喉罩组(40例)和气管插管组(40例)两组,所有患儿均给予全凭七氟醚吸入麻醉,喉罩组采用喉罩通气,而气管插管组则采用气管插管通气。监测T1(诱导后下颌松弛)、T2(喉罩置入或气管插管后1min)、T3(喉罩或气管插管拔出前)、T4(喉罩或气管插管拔出后1min)四个时间点的血流动力学指标并记录两组患儿置入喉罩或气管插管的次数、手术时间、手术结束至拔除喉罩或气管插管的时间,以及可能产生的不良反应。结果:喉罩组血流动力学指标在四个测量时间点的差异均无统计学意义(P>0.05);气管插管组血流动力学指标在四个测量时间点的差异均有统计学意义(P<0.05),其中T2时间点均高于T1时间点,T4时间点均高于T1、T3时间点。两组患儿置入喉罩或者气管插管次数、手术时间、手术结束至拔除喉罩或者气管插管时间的差异均无统计学意义(P>0.05);气管插管组患儿发生呛咳的比例高于喉罩组,差异有统计学意义(P<0.05);气管插管组患儿发生呛咳的比例高于喉罩组,差异有统计学意义(P<0.05)。结论:喉罩复合全凭七氟醚吸入麻醉可安全有效地应用于小儿眼科短小手术。
OBJECTIVE: To compare the advantages and disadvantages of laryngeal mask and endotracheal intubation with sevoflurane inhalation anesthesia for pediatric ophthalmic surgery. Methods: A total of 80 ASA Ⅰ ~ Ⅱ children undergoing ophthalmic surgery from January 2012 to December 2013 in our hospital were randomly divided into laryngeal mask group (40 cases) and tracheal intubation group (40 cases) All patients were given anesthesia by inhalation of sevoflurane, laryngeal mask group laryngeal mask ventilation, and intubation group is tracheal intubation ventilation. T1 (post-induction mandibular relaxation), T2 (laryngeal mask placement or endotracheal intubation 1min), T3 (laryngeal mask or endotracheal intubation before withdrawal), T4 (laryngeal mask or endotracheal intubation after withdrawal 1min) IV Hemodynamic parameters were recorded and the number of laryngeal mask or endotracheal intubation, the operation time, the time from the end of operation to the laryngeal mask removal or endotracheal intubation, and the possible adverse reactions were recorded. Results: There was no significant difference in the indexes of hemodynamics between the laryngeal mask group and the four measurement time points (P> 0.05). The differences of hemodynamics indexes in tracheal intubation group at four measurement time points were statistically significant (P <0.05), in which T2 time points were higher than T1 time points, T4 time points were higher than T1, T3 time points. There was no significant difference between the two groups in the number of laryngeal mask or endotracheal intubation, the operation time, the time from the end of surgery to the laryngeal mask removal or endotracheal intubation (P> 0.05). In the tracheal intubation group, cough (P <0.05). The incidence of choking in children with tracheal intubation was significantly higher than that in laryngeal mask group (P <0.05). Conclusion: Laryngeal mask compound sevoflurane inhalation anesthesia can be safely and effectively applied to pediatric ophthalmic surgery.