目的：探讨预氧非正压通气全麻诱导插管技术在腹腔镜胆囊摘除术中的安全性及可行性。方法笔者所在医院择期经腹腔镜胆囊摘除手术的患者48例，数字随机法分为两组：观察组（G）和对照组（D），每组患者为24例。 G组应用预氧非正压通气技术诱导插管，D组应用传统的胃管置入结合正压通气诱导插管。观察并记录两组患者入院时（T1）、诱导前5min（T2）、插管时（T3）、插管毕（T4）、插管后5min（T5）等5个时点的心率（HR），收缩压（SBP）、舒张压（DBP）、脉搏血氧饱和度（SpO2），记录T4、T5两个时点的呼气末二氧化碳分压（Pet－CO2）。评估胃胀情况。结果 T2时点，D组HR、SBP、DBP变化明显，组间组内比较，差异有统计学意义（P＜0．01）；G组T4时Pet－CO2点明显高于D组，差异有统计学意义（P＜0．05）。两组患者T3、T4、T5时点HR、SBP、DBP与组内T1比，差异有统计学意义（P＜0．05）。两组患者均无胃胀情况发生。结论应用预氧非正压通气技术全麻醉诱导插管，在腹腔镜胆囊摘除术是安全可行的。%Objective To discuss the safety and feasibility of pre-oxygen non-positive pressure ventilation anesthesia in laparoscopic gallbladder excision operation during induction and intubation. Methods The 48 patients admitted in author's hospital for undergoing elective laparoscopic cholecystectomy were randomly divided into two groups:observation group (G) and control group (D),each group had 24 cases. Group G adopted pre-oxygen non-positive pressure ventilation technology for induction and tracheal intubation ,group D conventional gastric tube implantation combined with positive pressure ventilation for induction and tracheal intubation. SBP , BP,HR and SpO2 were recorded at 5 time pionts such as admission (T1),5 min before the induction(T2),when intubation (T3),just end of intubation (T4),5 min after intubation (T5);and Pet-CO2 at T4,T5 were recorded. Bloating situation was estimated. Results In group D,SBP,DBP and HR at T2 were higher than at T1 and at the same time points in group G (P<0.01);Pet-CO2 was higher group G than group D at T4 (P<0.01);in two groups,SBP,DBP and HR at T3,T4,T5 were more obvious than at T1 (P<0.05). All patients of both groups had no bloating. Conclusion Pre-oxygen non-positive pressure ventilation technology of full induction of anesthesia intubation in laparoscopic cholecystectomy is safe and feasible.
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