喉罩连接三通接头在小儿支气管肺泡灌洗术中的应用  

Use of laryngeal mask airway with union tee for bronchoalveolar lavage in pediatric patients

作　　者：陶炳东[1] 李云峰[1] 张锦[1] 陈卫民[1] 张秉钧[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳市110004

出　　处：《临床麻醉学杂志》2012年第8期762-764,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察喉罩连接三通接头在小儿支气管肺泡灌洗术(BAL)中的应用效果。方法行BAL的患儿38例,年龄2～13岁,随机分为三组:喉罩组(L组,n=14)和气管插管组(T组,n=12)在全麻快速诱导后分别插入喉罩和气管导管,成功后连接三通接头,采用吸入全麻;面罩组(M组,n=12)采用静脉全麻,间断吸入七氟醚。观察患儿MAP、HR和SpO2变化,以及术中呛咳、体动发生情况。结果 M组手术时间和麻醉时间均长于L组和T组(P<0.01)。纤支镜通过隆突和灌洗时M组MAP和HR显著高于麻醉前,且明显高于L组和T组(P<0.01);SpO2明显降低(P<0.01)。与M组比较,纤支镜插入气管后L组和T组SpO2明显升高(P<0.01)。结论喉罩连接三通接头全麻应用于小儿BAL,经过平稳,保证充分氧供。Objective To investigate the feasibility and safety of laryngeal mask airway（LMA） with union tee during pediatric bronchoalveolar lavage （BAL）. Methods Thirty-eight children undergoing BAL were divided into three groups： LMA group（group L, n= 14）, trachea tube group （group T, n = 12） and mask group （group M, n = 12）. All the patients received intravenous anesthesia and intermittent sevoflurane inhalation. Hemodynamics, SpO2, coughing and body movement were recorded in each group. Results The operation time and anesthesia time were longer in group M than in group L and group T（P〈0. 01）. MAP and HR in group M were higher and SpO2 was lower than baseline and than those in group L and group T when the fibrotic bronchoscopy reaching carina and during lavage. SpO2 in group L and group T increased after bronchoscopy insertion. Conclusion It will provide a safe and stable condition for BAL in pediatric patients when using LMA and union tee.

关 键 词：喉罩 小儿 支气管肺泡灌洗术 

分 类 号：R726.1[医药卫生—儿科]