中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
18期
18-20
,共3页
喉面罩%气道管理
喉麵罩%氣道管理
후면조%기도관리
Laryngeal masks%Airway management
目的 比较全身麻醉手术患者i-gel喉罩和SLIPA喉罩气道管理的效果.方法 择期全身麻醉手术患者60例,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为i-gel喉罩组和SLIPA喉罩组,每组30例.麻醉诱导后置入喉罩,行机械通气.喉罩置入成功后行纤维支气管镜检查分级.记录最高气道压、平均气道压、喉罩置入成功情况、置入时间、喉罩拔除时间、苏醒时间、喉罩拔除时罩体带血和反流及术后1、24h咽喉部疼痛的发生情况.结果 两组麻醉时间、手术时间、喉罩拔除时间、苏醒时间、首次置入成功率、二次置入成功率、喉罩置入时间、最高气道压和平均气道压比较差异均无统计学意义(P＞0.05).i-gel喉罩组气道密封压高于SLIPA喉罩组[(29±6) cm H2O(1 cm H2O=0.098 kPa)比(23±4)cm H2O],差异有统计学意义(P＜0.05).i-gel喉罩组纤维支气管镜检查分级1级27例、2级3例,SLIPA喉罩组1级3例、2级4例、3级13例、4级10例,i-gel喉罩组明显优于SLIPA喉罩组,差异有统计学意义(P＜0.05).i-gel喉罩组罩体带血及术后1、24h咽喉部疼痛均为2例(6.7％),SLIPA喉罩组分别为5例(16.7％)、8例(26.7％)、7例(23.3％),i-gel喉罩组各发生率均低于SLIPA喉罩组,差异有统计学意义(P＜0.05).两组均未发生反流和误吸.结论 i-gel喉罩和SLIPA喉罩用于全身麻醉均可保证有效正压通气,但i-gel喉罩气道密封压高,不良反应少,气道管理效果更好.
目的 比較全身痳醉手術患者i-gel喉罩和SLIPA喉罩氣道管理的效果.方法 擇期全身痳醉手術患者60例,ASA分級Ⅰ或Ⅱ級,採用隨機數字錶法分為i-gel喉罩組和SLIPA喉罩組,每組30例.痳醉誘導後置入喉罩,行機械通氣.喉罩置入成功後行纖維支氣管鏡檢查分級.記錄最高氣道壓、平均氣道壓、喉罩置入成功情況、置入時間、喉罩拔除時間、囌醒時間、喉罩拔除時罩體帶血和反流及術後1、24h嚥喉部疼痛的髮生情況.結果 兩組痳醉時間、手術時間、喉罩拔除時間、囌醒時間、首次置入成功率、二次置入成功率、喉罩置入時間、最高氣道壓和平均氣道壓比較差異均無統計學意義(P＞0.05).i-gel喉罩組氣道密封壓高于SLIPA喉罩組[(29±6) cm H2O(1 cm H2O=0.098 kPa)比(23±4)cm H2O],差異有統計學意義(P＜0.05).i-gel喉罩組纖維支氣管鏡檢查分級1級27例、2級3例,SLIPA喉罩組1級3例、2級4例、3級13例、4級10例,i-gel喉罩組明顯優于SLIPA喉罩組,差異有統計學意義(P＜0.05).i-gel喉罩組罩體帶血及術後1、24h嚥喉部疼痛均為2例(6.7％),SLIPA喉罩組分彆為5例(16.7％)、8例(26.7％)、7例(23.3％),i-gel喉罩組各髮生率均低于SLIPA喉罩組,差異有統計學意義(P＜0.05).兩組均未髮生反流和誤吸.結論 i-gel喉罩和SLIPA喉罩用于全身痳醉均可保證有效正壓通氣,但i-gel喉罩氣道密封壓高,不良反應少,氣道管理效果更好.
목적 비교전신마취수술환자i-gel후조화SLIPA후조기도관리적효과.방법 택기전신마취수술환자60례,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법분위i-gel후조조화SLIPA후조조,매조30례.마취유도후치입후조,행궤계통기.후조치입성공후행섬유지기관경검사분급.기록최고기도압、평균기도압、후조치입성공정황、치입시간、후조발제시간、소성시간、후조발제시조체대혈화반류급술후1、24h인후부동통적발생정황.결과 량조마취시간、수술시간、후조발제시간、소성시간、수차치입성공솔、이차치입성공솔、후조치입시간、최고기도압화평균기도압비교차이균무통계학의의(P＞0.05).i-gel후조조기도밀봉압고우SLIPA후조조[(29±6) cm H2O(1 cm H2O=0.098 kPa)비(23±4)cm H2O],차이유통계학의의(P＜0.05).i-gel후조조섬유지기관경검사분급1급27례、2급3례,SLIPA후조조1급3례、2급4례、3급13례、4급10례,i-gel후조조명현우우SLIPA후조조,차이유통계학의의(P＜0.05).i-gel후조조조체대혈급술후1、24h인후부동통균위2례(6.7％),SLIPA후조조분별위5례(16.7％)、8례(26.7％)、7례(23.3％),i-gel후조조각발생솔균저우SLIPA후조조,차이유통계학의의(P＜0.05).량조균미발생반류화오흡.결론 i-gel후조화SLIPA후조용우전신마취균가보증유효정압통기,단i-gel후조기도밀봉압고,불량반응소,기도관리효과경호.
Objective To compare the effect between i-gel mask and SHPA mask in the airway management of general anesthesia.Methods Sixty patients of general anesthesia with ASA I or Ⅱ were randomly divided into two groups:i-gel mask group (30 cases) and SLIPA group(30 cases).After intubation and general anesthesia,fiberoptic bronchoscopy was used to detect and evaluate.The peak airway pressure,mean airway pressure,condition of the laryngeal mask intubation,time of intubation,time of extubation,time of recovery and the side effect occurrence of extubation were recorded.Results The time of anesthesia,time of operation,time of extubation,time of recovery,achievement ratio of first time,achievement ratio of second time,time of intubation,peak airway pressure and mean airway pressure had no significant difference between two groups (P ＞ 0.05).The airway seal pressure in i-gel mask group was significantly higher than that in SL1PA group [(29 + 6) cm H2O (1 c m H2O =0.098 kPa) vs.(23 ± 4) cm H2O] (P ＜ 0.05).For the grade of fiberoptic bronchoscopy in i-gel mask group,there was 27 patients in I grade,3 patients in Ⅱ grade.But in SL1PA group,there was 3 patients in I grade,4 patients in Ⅱ grade,13 patients in Ⅲ grade,10 patients in ⅣVgrade.There was significant difference between two groups (P ＜ 0.05).There were none of regurgitation in two groups.Conclusions The i-gel mask and SLIPA mask can provide the same effective ventilation.The i-gel mask has higher airway seal pressure,less side effect during the intubation and extubation,and have better airway management of general anesthesia.
