中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
21期
6-8
,共3页
段宏军%贾瑞芳%李大航%左明章
段宏軍%賈瑞芳%李大航%左明章
단굉군%가서방%리대항%좌명장
喉面罩%呼吸,人工%密封压
喉麵罩%呼吸,人工%密封壓
후면조%호흡,인공%밀봉압
Laryngeal masks%Respiration,artificial%Seal pressure
目的 探讨SLIPA喉罩在全麻气道管理中的有效性.方法 择期全麻下行乳腺肿物切除术的女性患者60例,ASA分级Ⅰ～Ⅱ级,电脑排位随机分为SLIPA喉罩组(S组)和普通喉罩组(L组),每组各30例.诱导用药为普鲁泊福2mg/kg、舒芬太尼0.15μg/kg和维库溴铵0.08mg/kg,维持用药为50%氧化亚氮-50%氧气和1%～29%七氟烷,麻醉机参数设置相同.两组患者均根据体重选择喉罩型号,采用徒手法置入.记录喉罩置入次数、气道密封压、纤维支气管镜检查声带显露评分;记录喉罩置入成功后每隔15 min的脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PERCO2)、气道峰压;观察拔出喉罩后咽喉痛、反流误吸发生情况;记录手术时间、麻醉时间、拔喉罩时间、苏醒时间.结果 两组喉罩置入成功率均为100%,S组1次置入成功率(90%,27/30)明显高于L组(60%,18/30)(P<0.05);S组纤维支气管镜检查声带显露评分为4分者(20例)多于L组(11例)(P<0.05);S组气道密封压为(23.6±4.7)cm H2O(1 cm H2O=0.098 kPa),L组为(18.8±4.5)cm H2O,两组比较差异有统计学意义(P<0.05).置入喉罩后两组所观察的各时段的SpO2、PErCO2、气道峰压均在正常范围内.拔出喉罩后咽喉痛S组7例,L组6例,两组均无反流误吸情况发生.结论 SLIPA喉罩操作简单易行,密封效果好,能有效地进行正压通气,不良反应少,能安全有效地用于全麻气道管理.
目的 探討SLIPA喉罩在全痳氣道管理中的有效性.方法 擇期全痳下行乳腺腫物切除術的女性患者60例,ASA分級Ⅰ～Ⅱ級,電腦排位隨機分為SLIPA喉罩組(S組)和普通喉罩組(L組),每組各30例.誘導用藥為普魯泊福2mg/kg、舒芬太尼0.15μg/kg和維庫溴銨0.08mg/kg,維持用藥為50%氧化亞氮-50%氧氣和1%～29%七氟烷,痳醉機參數設置相同.兩組患者均根據體重選擇喉罩型號,採用徒手法置入.記錄喉罩置入次數、氣道密封壓、纖維支氣管鏡檢查聲帶顯露評分;記錄喉罩置入成功後每隔15 min的脈搏血氧飽和度(SpO2)、呼氣末二氧化碳分壓(PERCO2)、氣道峰壓;觀察拔齣喉罩後嚥喉痛、反流誤吸髮生情況;記錄手術時間、痳醉時間、拔喉罩時間、囌醒時間.結果 兩組喉罩置入成功率均為100%,S組1次置入成功率(90%,27/30)明顯高于L組(60%,18/30)(P<0.05);S組纖維支氣管鏡檢查聲帶顯露評分為4分者(20例)多于L組(11例)(P<0.05);S組氣道密封壓為(23.6±4.7)cm H2O(1 cm H2O=0.098 kPa),L組為(18.8±4.5)cm H2O,兩組比較差異有統計學意義(P<0.05).置入喉罩後兩組所觀察的各時段的SpO2、PErCO2、氣道峰壓均在正常範圍內.拔齣喉罩後嚥喉痛S組7例,L組6例,兩組均無反流誤吸情況髮生.結論 SLIPA喉罩操作簡單易行,密封效果好,能有效地進行正壓通氣,不良反應少,能安全有效地用于全痳氣道管理.
목적 탐토SLIPA후조재전마기도관리중적유효성.방법 택기전마하행유선종물절제술적녀성환자60례,ASA분급Ⅰ～Ⅱ급,전뇌배위수궤분위SLIPA후조조(S조)화보통후조조(L조),매조각30례.유도용약위보로박복2mg/kg、서분태니0.15μg/kg화유고추안0.08mg/kg,유지용약위50%양화아담-50%양기화1%～29%칠불완,마취궤삼수설치상동.량조환자균근거체중선택후조형호,채용도수법치입.기록후조치입차수、기도밀봉압、섬유지기관경검사성대현로평분;기록후조치입성공후매격15 min적맥박혈양포화도(SpO2)、호기말이양화탄분압(PERCO2)、기도봉압;관찰발출후조후인후통、반류오흡발생정황;기록수술시간、마취시간、발후조시간、소성시간.결과 량조후조치입성공솔균위100%,S조1차치입성공솔(90%,27/30)명현고우L조(60%,18/30)(P<0.05);S조섬유지기관경검사성대현로평분위4분자(20례)다우L조(11례)(P<0.05);S조기도밀봉압위(23.6±4.7)cm H2O(1 cm H2O=0.098 kPa),L조위(18.8±4.5)cm H2O,량조비교차이유통계학의의(P<0.05).치입후조후량조소관찰적각시단적SpO2、PErCO2、기도봉압균재정상범위내.발출후조후인후통S조7례,L조6례,량조균무반류오흡정황발생.결론 SLIPA후조조작간단역행,밀봉효과호,능유효지진행정압통기,불량반응소,능안전유효지용우전마기도관리.
Objective To evaluate the efficacy of streamline liner of pharyngeal airway ( SLIPA) in airway management of general anesthesia. Methods Sixty ASA Ⅰ -Ⅱ patients undergoing elective breast surgery were randomized into 2 groups (30 cases each): SLIPA group (group S) and laryngeal mask airway (LMA) classic group (group L). Anesthesia was induced with propofol 2 mg/kg, sufentanil 0.15 μ g/kg and vecurium 0.08 mg/kg. SLIPA or LMA was inserted with digital manipulation. Anesthesia was maintained with 1% - 2% sevofluran and 50% N2O in 50% oxygen. The parameters of controlled ventilation were same in both groups. The attempt times, seal pressure and grade of fiberoptic (FOB ) laryngoscopy were measured. SpO2, PErCO2 and peak airway pressure were monitored every 15 minutes after successful laryngeal mask insertion. The complications such as regurgitation of gastric contents and sore throat were assessed by anesthesiologist after surgery. Surgery time, anesthesia time, extubation time and emergence time were recorded. Results Success rate of LMA insertion in both groups were 100%. The first attempt success rates were 90%( 27/30) in group S and 60%( 18/30) in group L (P< 0.05), the FOB grade 4 were 67%(20/30) in group S and 37% (ll/30)in group L(P< 0.05), the maximum seal pressures were (23.6 ± 4.7)cmH2O (1 cm H2O = 0.098 kPa) in group S and (18.8 ± 4.5) cm H2O in group L (P<0.05). SpO2, PErCO2 and peak airway pressure were within normal ranges. The occurrence of sore throat was similar in group S and group L (7 cases vs 6 cases). No signs of regurgitation were detected. Conclusion The SLIPA proved to be a simple, safe and effective airway instrument with little complications during the course of general anesthesia.
