喉罩联合T型密封接头控制通气在无痛纤维支气管镜检查中的应用  

Application of controlled ventilation with laryngeal mask airway and T-seal adapter in fiberoptic bronchoscopy

作　　者：陈伟[1] 李卫[1] 夏氢[1] 王健[2] 

机构地区：[1]四川省绵阳市中心医院麻醉科,621000 [2]四川省绵阳市中心医院手术室,621000

出　　处：《实用医学杂志》2010年第11期1945-1947,共3页The Journal of Practical Medicine

基　　金：四川省卫生厅科研基金资助项目(编号:080218)

摘　　要：目的:观察喉罩联合T型密封接头控制通气在无痛纤维支气管镜检查中的应用效果。方法:选择ASAⅠ～Ⅱ级,年龄20～65岁,拟行无痛纤维支气管镜检查的患者40例,随机分为控制通气组(C组,n=20)和自主呼吸组(S组,n=20)。前者通过喉罩联合T型密封接头实施控制通气,而后者则保持自主呼吸,必要时经面罩辅助通气。观察记录两组患者检查中平均动脉压(MAP)、心率(HR)及脉搏血氧饱和度(SpO2)的变化,记录两组患者的镜检条件及镜检时间,观察检查中的不良反应。结果:S组患者的HR在纤维支气管镜通过声门时显著升高,检查中的SpO2明显下降(P<0.05)。而C组患者HR变化不明显,SpO2维持在较高水平。C组患者的镜检条件明显优于S组,镜检时间显著短于S组(P<0.05)。C组患者检查中出现呛咳、憋气、喉痉挛及体动等不良反应明显少于S组(P<0.05)。结论:喉罩联合T型密封接头控制通气可安全应用于无痛纤维支气管镜检查,能有效控制患者的气道,解决检查中的呼吸抑制问题,显著改善镜检条件。Objective To observe the clinical effect of controlled ventilation with laryngeal mask airway and T-seal adapter in fiberoptic bronchoscopy.Methods Forty ASA Ⅰ～Ⅱ grade patients undergoing fiberoptic bronchoscopy, aged 20-65 years, were randomly divided into controlled ventilation group（Group C, n = 20） and spontaneous ventilation group（Group S, n = 20）.Controlled ventilation was adopted in Group C, supported by laryngeal mask airway combined with T-seal adapter.The patients in Group S maintained spontaneous respiration, and could receive assisted ventilation via face mask if necessary.The mean arterial pressure（MAP）, heart rate（HR） and pulse oxygen saturation（SpO2） were evaluated during endoscope inspection.The operating condition and operating time of the two groups were recorded, side-effects during the inspection were also observed.Results The HR of the patients in Group S markedly raised when the flexible fiberoptic bronchoscope went through the glottis（P 0.05）, and the SpO2 obviously decreased during inspection（P 0.05）.However, the SpO2 of the patients in Group C remained at a higher level.The operating condition in Group C was significantly superior to the Group S（P 0.05）, and the operating time in Group C was significantly shorter than that in Group S（P 0.05）.Less irritating cough, breathlessness, laryngospasm, and body movement happened in Group C than those in Group S（P 0.05）.Conclusion Controlled ventilation with laryngeal mask airway and T-seal adapter is a safe and effective alternative to fiberoptic bronchoscopy.

关 键 词：支气管镜检查 喉罩 T型密封接头 控制通气 

分 类 号：R56[医药卫生—呼吸系统]