三通喉罩通气在肺纤支镜病理活检中的应用  

Efficacy of three-way laryngeal mask airway ventilation in pathologic biopsy of lung through fibrobronchoscope

作　　者：农江[1] 杨天明[1] 陆卫忠[1] 欧莉[1] 许建能[1] 韦海雷[1] 

机构地区：[1]中国人民解放军第三0三医院,广西南宁530021

出　　处：《热带医学杂志》2011年第2期189-191,196,共4页Journal of Tropical Medicine

摘　　要：目的探讨三通喉罩通气在肺病理活检中的应用。结论对需实施肺活检的25例次成人患者,在快速诱导麻醉下实施三通喉罩插入,标准端口连接麻醉机进行机械通气,另一带有密封胶帽端口置入纤维支气管镜,实施肺活检、肺部止血术。记录麻醉前5min时(T0)、插入喉罩后即刻(T1)、通气1min时(T2)、通气5min时(T3)、通气10min时(T4)、手术结束时(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO2);记录患者通气T1、T2、T3、T4、T5、的潮气量(VT)、气道峰压(Ppeak)及呼气末二氧化碳分压(PETCO2);测定T0,T2、T3、T4时间点的血气分析。结果 21例、25次操作中SBP、DBP、HR、VT、AP及PETCO2无明显变化,手术均顺利完成,采取的病理标本满意,诊断明确。术后恢复良好,无明显并发症。结论三通喉罩用于肺活检具有安全、可靠、并发症少等优点,方便了手术操作,提高了病人的安全性和舒适性。Objective To study the efficacy of three-way laryngeal mask airway （TLMA） ventilation in fibrobronchoscope in lung. Methods 21 patients aged from 17 to 88 years and admitted for tracheal intubation with TLMA under general anesthesia in fibrobronchoscope in lung.SBP,DBP,HR,and SPO2 were measured at 5 min after entering the surgery（T0）,immediately after inserting TLMA（T1）,1 min after ventilation（T2）,5 min after ventilation（T3）,10 min after ventilation（T4）and immediately end of operation（T5）.Peak inspiratory airway pressure（Ppeak）, tidal volume（VT）and expiratory CO2 presure（PETCO2）were recorded at T1,T2,T3,T4,T5.Blood specimens were taken at T0,T2,T3,T4 for blood gas analysis.Effect of anesthesia and operation were recorded. Results All the operations were successful, satisfactory effects were observed in the 13 cases under study. No side effect and complications were observed in all cases. Conclusions TLMA for fibrobronchoscope in lung is a simple,safe and economical method.Adopting TLMA to management respiration in general anesthesia undergoing fibrobronchoscope in lung would control respiration according to demand at any time.It may make patients more safe and comfortable.

关 键 词：三通喉罩 肺病理活检 全麻 

分 类 号：R446.8[医药卫生—诊断学]