喉罩在儿童上颌前牙区埋伏牙拔除中应用的研究

doi:10.13591/j.cnki.kqyx.2023.11.009

摘要/Abstract

摘要：

目的研究喉罩在儿童上颌前牙区埋伏牙拔除术中的临床应用效果。方法将116例患儿随机分为喉罩组(L组,n=58)和气管插管组(T组,n=58)。记录麻醉诱导前(T0)、喉罩/气管插管前(T1)、喉罩/气管插管后(T2)的血压和心率;记录拔管时间,术后呛咳、躁动、咽痛和发热的发生率。结果组间比较显示,T2时,T组患者收缩压(SP)、舒张压(DP)和心率(HR)较L组显著升高(P<0.05)。组内比较显示,L组T2的SP、HR与T1相比显著增加(P<0.05),但其DP与T1组相比,结果差异无统计学意义(P>0.05);T组T2的SP、DP、HR与T1相比均显著增加(P<0.05)。L组和T组相比,患儿拔管时间显著缩短,拔管时呛咳、躁动的发生率显著下降(P<0.05);术后咽痛的发生率显著下降(P<0.05)。结论在儿童上颌前牙区埋伏牙拔除术中,使用喉罩通气更有利于维持患儿麻醉过程中的血流动力学稳定,且能显著降低患儿拔管时和术后不良反应的发生。

关键词: 喉罩, 上颌前牙区, 儿童, 埋伏牙

Abstract:

Objective To evaluate clinical effects of laryngeal mask airway (LMA) on impacted tooth extraction in the anterior maxillary region of children. Methods A total of 116 children were randomly divided into laryngeal mask group (L group, n=58) and endotracheal intubation group (T group, n=58). Blood pressure and heart rates were recorded before induction of anesthesia(T0), before laryngeal mask/tracheal intubation(T1), and after laryngeal mask/endotracheal intubation inserting(T2). We also recorded the time of extubation, the incidence of coughing and agitation during extubation and the incidence of sore throat and fever after surgery. Results At T2, systolic pressure(SP)、diastolic pressure(DP)and heart rate(HR)increased significantly in the T group (P<0.05). In L group, SP, HR at T2 increased significantly compared to T1 (P<0.05), but no significant difference was shown for DP (P>0.05). In T group, SP, DP, HR were all increased at T2 compared to T1 in L group (P<0.05). The blood pressure and heart rate of T2 in T group increased significantly compared with T1; at the same time, it also increased significantly compared with T2 in L group(P<0.05). The extubation time, the incidence of coughing and agitation during extubation in L group was significantly reduced compared with those in T group(P<0.05). Also, the incidence of postoperative sore throat decreased significantly compared with the T group(P<0.05). Conclusion Using LMA in the extraction of impacted teeth in the maxillary anterior region of children, is more conducive to maintaining hemodynamic stability during anesthesia and can significantly reduce the occurrence of adverse reactions during extubation and after surgery in children.

Key words: laryngeal mask airway (LMA), maxillary anterior tooth area, child, impacted tooth

中图分类号:

R782

冯彩华, 张丽娜, 刘冰. 喉罩在儿童上颌前牙区埋伏牙拔除中应用的研究[J]. 口腔医学, 2023, 43(11): 1014-1018.

FENG Caihua, ZHANG Lina, LIU Bing. Application of laryngeal mask airway in the extraction of impacted teeth in the anterior maxillary region of children[J]. Stomatology, 2023, 43(11): 1014-1018.

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基本资料	T组	L组	t	P^*
年龄/岁	3.53±1.16	3.66±1.20	0.55	0.75
体重/kg	19.50±4.20	18.40±4.55	1.36	0.55
手术时间/min	29.55±4.75	30.14±5.37	0.62	0.36

监测指标	分组	T0	T1	T2	F	P
SP/mmHg	T	90±5	80±3	98±4^*#	18.21	0.00
	L	90±6	78±5	82±3^*	60.53	0.03
t		0.94	0.28	4.87	—	—
P		0.73	0.99	0.000 1	—	—
DP/mmHg	T	41±3	36±4	45±3^*#	10.27	0.00
	L	46±6	37±2	39±2	14.56	0.34
t		2.39	0.85	2.99	—	—
P		0.07	0.78	0.02	—	—
HR/(次/min)	T	109±9	84±5	107±8^*#	16.99	0.01
	L	104±8	85±6	96±7^*	17.98	0.04
t		1.12	0.16	2.63	—	—
P		0.62	0.10	0.04	—	—

组别	躁动(例)	呛咳(例)	咽痛(例)	发热(例)
T组	15	20	18	4
L组	5^*	6^*	4^*	2
χ²	6.04	9.72	10.99	0.83
P	0.01	<0.01	<0.01	0.36