双管喉罩与Macintosh喉镜在紧急气道开放中的比较研究  

Comparison of proseal laryngeal mask airway and Macintosh laryngoscope for emergency airway opening

作　　者：徐海洲[1] 王美堂[1] 梅冰[1] 何建[1] 

机构地区：[1]第二军医大学附属长海医院急诊科,上海200433

出　　处：《成都医学院学报》2012年第02Z期119-120,共2页Journal of Chengdu Medical College

摘　　要：目的：在急诊应用Macintosh喉镜与双管喉罩进行紧急气道开放的比较，评价双管喉罩在急诊临床应用的优势。方法：选择2011年10月至2011年12月期间于长海医院急诊科抢救室80例需紧急气道开放的患者，随机分为两组：M组应用Macintosh喉镜进行气管插管，L组应用双管喉罩进行气道开放。分别记录两组建立有效气道的时间、一次性插管成功率、插管后并发症的发生率，以及插管前后患者心率（HR）、平均动脉压（MAP）、氧饱和度（SP02）等血流动力学指标变化。结果：L组插管平均完成时间显著短于M组（24．654．32s vs45．5610．45s，P〈0．01）；L组一次性插管成功率显著高于M组（100％vs85％，P〈0．05）；牙齿松动出血与口腔粘膜出血的发生率显著低于M组（0％vs15％，P〈0．05）；两组均未发生返流、误吸的并发症；M组患者在插管后lminHR，MAP明显上升，较L组有显著差异（P〈0．05），而两组患者在插管后1rainSP02均明显上升，两组间比较无显著差异性（P〉0．05）。结论：双管喉罩相较Macintosh喉镜插管诛度更快．一坎性插管成功率更高．对血流动力学影响小．并发症少。并能有效改善病人缺氧状况，值得在急救领域中推广应用。Objective To evaluate the effectiveness and advantage of the proseal laryngeal mask airway in comparison with the Macintosh laryngoscope for the emergency airway opening. Method 80 patients in need for emergency airway opening in our first - aid room from October to December 2011 were randomly divided into two groups ： proseal laryngeal mask airway group （ L group） and Macintosh laryngoscope group （ M group）. The time taken for successful intubation, the successful rates of first iutubation and the complications during intubation were recorded. Variation of hemodynamie parameters including HR, MBP and SPO2 were observed before and after intubation. Results The intubation time in the L group was significantly shorter than that in the M group （24. 654.32s vs 45. 5610.45s, P 〈 0.01 ）. The successful rates of first intubation in the L group were obviously higher than that in the M group（ 100% vs 85% , P 〈0.05）. The incidence of tooth loosen or bleeding and oral mucosal bleeding in the L group was 0%, which was much lower than that in the M group （ 15%, P 〈 0.05 ）. However, the complications of reflux and aspiration were not occurred in the two groups. The parameters of HR and MAP in the M Group elevated significantly at the time of 1 rain after intubation compared with the L Group （ P 〈 0.05 ）. The parameter of SPO2 increased in Both M Group and L Group at the same time, and there were no significantly difference between the two groups （ P 〉 0.05 ）. Conclusions Compared with Macintosh laryngoscope, using proseal laryngeal mask airway can open airway more quickly, and lead to higher successful rates of first intubation. It can keep stable hemodynamics, produce less complications and effectively ameliorate the hypoxia in patients. Therefore, proseal laryngeal mask airway is worth to promote application in the emergency region.

关 键 词：双管喉罩 MACINTOSH喉镜 紧急气道开放 

分 类 号：R322.33[医药卫生—人体解剖和组织胚胎学]