CAJ | 학술논문

目的：探讨老年患者无痛纤支镜检查应用改良喉罩进行气道管理的可行性与应用效果。方法以2012年1月～2013年5月在我院行无痛纤支镜检查的108例老年患者作为研究对象，并随机分为局麻组和改良喉罩组，每组各54例。观察两组患者喉罩的插入情况、患者基本情况以及不良反应进行观察和比较分析。结果局麻组患者手术中和手术后的血压和心率均较术前明显增高，而血氧饱和度在术中明显降低，改良喉罩组患者其血压和心率则均较术前明显降低，在血氧饱和度方面均未表现出明显变化。两组患者各项指标在手术中和手术后均有明显差异性（p＜0.05），改良喉罩组患者无一例患者出现不良反应，其发生率较局麻组显著降低，且在患者满意度得分上也明显优于局麻组（p＜0.05），差异具有统计学意义。并且改良后插入喉罩的完成时间均≤3 min，一次性置入成功率为98.15％。结论改良喉罩后行全麻无痛纤支镜检查可有效稳定老年患者的血压、心率以及血氧饱和度，同时也能避免出现呛咳、喉痉挛及拔除喉罩后低氧血症等不良反应，缩短喉罩插入的操作时间，提高一次性成功率，值得临床推广使用。
목적：탐토노년환자무통섬지경검사응용개량후조진행기도관리적가행성여응용효과。방법이2012년1월～2013년5월재아원행무통섬지경검사적108례노년환자작위연구대상，병수궤분위국마조화개량후조조，매조각54례。관찰량조환자후조적삽입정황、환자기본정황이급불량반응진행관찰화비교분석。결과국마조환자수술중화수술후적혈압화심솔균교술전명현증고，이혈양포화도재술중명현강저，개량후조조환자기혈압화심솔칙균교술전명현강저，재혈양포화도방면균미표현출명현변화。량조환자각항지표재수술중화수술후균유명현차이성（p＜0.05），개량후조조환자무일례환자출현불량반응，기발생솔교국마조현저강저，차재환자만의도득분상야명현우우국마조（p＜0.05），차이구유통계학의의。병차개량후삽입후조적완성시간균≤3 min，일차성치입성공솔위98.15％。결론개량후조후행전마무통섬지경검사가유효은정노년환자적혈압、심솔이급혈양포화도，동시야능피면출현창해、후경련급발제후조후저양혈증등불량반응，축단후조삽입적조작시간，제고일차성성공솔，치득림상추엄사용。
Objective To study of improved laryngeal mask airway of painless fiber endoscopy in elderly patients with painless bronchoscopy.Methods To choose 108 cases of elderly patients who were treated with painless fiber endoscopy in our hospital from January 2012 to May 2013 as the research objects, and were randomly divided into the local anesthesia group and the improved laryngeal mask group, each group was 54 cases.Observed and compared the laryngeal mask insertion, patients′basic situation and adverse reactions of patients in two groups .Results The blood pressure and heart rate in surgery and postoperative of patients in the local anesthesia group were significantly higher, and the intraoperative blood oxygen satu-ration was significantly lower, but the blood pressure and heart rate in surgery and postoperative of patients in the improved la-ryngeal mask group were significantly lower than that of preoperative, and it showed no significant change in the aspect of blood oxygen saturation.The indicators of patients in two groups in surgery and after surgery, had significant difference (p<0.05), none of the patients in the improved laryngeal mask group had adverse reactions, and its incidence was significantly reduced comparing with the local anesthesia group, and the patient satisfaction scores of the improved laryngeal mask group were obviously better than that of the local anesthesia group (p<0.05), the difference was statistically significant.And the completion time of inserting improved laryngeal mask was 3 min or less, a one-time placement success rate was 98.15%. Conclusion The improved laryngeal mask airway of painless fiber endoscopy can effective stabilize the blood pressure , heart rate and blood oxygen saturation of elderly patients, at the same time also can avoid choking cough, laryngospasm and pulling hypoxemia and other adverse reactions after laryngeal mask, shorten the operation time of laryngeal mask insertion and in-crease the one-time success rate, so it is worthy of clinical use.