喉罩并胃管引流用于择期胃肿瘤手术全麻的安全性和有效性  

Efficacy and safety of application of LMA combined with stomach-tube draining during general anesthesia for gastrectomy

作　　者：杨扬[1] 马曙亮[1] 顾连兵[1] 黄凤伦[1] 孙来荣[1] 卞清明[1] 

机构地区：[1]江苏省肿瘤医院麻醉科,南京210009

出　　处：《江苏医药》2009年第7期780-782,共3页Jiangsu Medical Journal

摘　　要：目的探讨喉罩(LMA)并胃管引流用于择期胃肿瘤手术的安全性和有效性。方法胃肿瘤手术患者40例,术前置好16号硅胶胃管。常规全麻诱导,在确认LMA插入到位后行纤支镜评分,术中用旁气流通气监护仪(SSS)监测气道密闭压(Pseal)及相关通气指标。术毕用pH试纸检测拔管后LMA尖端分泌物pH值,并观察患者有无严重咳嗽和气道激惹。结果40例患者均成功插入LMA,LMA位置纤支镜评4、3、2、1分的分别为11、2、23、4例。Pseal为(17.0±5.1)cmH2O。与SSS置管后比较,术中气道峰压和气道阻力增加,胸肺顺应性下降(P<0.05orP<0.05)。LMA尖端分泌物pH>4,无一例患者发生严重咳嗽和气道激惹。结论LMA并胃管引流用于择期胃肿瘤手术全麻通气安全有效,不会发生返流误吸。Objective To investigate the efficacy and safety of application of laryngeal mask airway（LMA） combined with stomach-tube draining during general anesthesia for gastrectomy. Methods A size 16 gastric tube was placed preoperatively in 40 patients undergoing elective gastric tumor surgery under general anesthesia. After LMA was inserted successfully, a fibreoptic bronchoscopy was used to evaluate the position of LMA, and side stream spirometry（SSS） was used to monitor airway seal pressure（Pseal） and respiratory criteria. The secretion on the tip of LMA at the end of surgery was tested with paper pH indicator and the cough and airway irritation of patients were observed. Rusults LMA placement was all successful. The LMA position scored 4 in 11 cases,3 in 2 cases, 2 in 23 cases, and 1 in 4 cases, respectively. The Pseal of LMA was （17. 0 ± 5.1） cm H2O. Peak inspiratory pressure and airway resistance were increased and lung compliance was decreased during operation compared with those after SSSS placement （P〈0. 05 or P〈0. 05）. The pH values of secretion on the tip of LMA were all greater than 4. No heavily cough and airway irritation were observed. Conclution LMA combined with stomach-tube draining can be used effectively and safely in the patients undergoing selective stomach tumor surgery without regurgitation and asperation.

关 键 词：喉罩 胃管引流 胃肿瘤 全麻 

分 类 号：R614[医药卫生—麻醉学]