经三通喉罩行全身麻醉下球囊扩张治疗气道狭窄60例临床分析  

Clinical analysis of 60 cases of airway stenosis in balloon dilatation using three-way laryngeal mask under general anesthesia

作　　者：宋炯[1] 段若望[1] 吕欣[1] 

机构地区：[1]同济大学附属上海市肺科医院麻醉科,上海200433

出　　处：《中国内镜杂志》2013年第7期725-728,共4页China Journal of Endoscopy

基　　金：上海市级医院适宜技术联合开发推广应用项目(No.SHDC12010214)

摘　　要：目的探讨三通喉罩用于全身麻醉下球囊扩张治疗气道狭窄的优越性。方法分析该院2011年2月~2011年5月经三通喉罩行全麻下球囊扩张治疗气道狭窄患者60例,其中男性17例,女性43例;年龄16~68岁,体重38~82 kg,ASA 1~2级。入室后快速诱导,插入三通喉罩,接麻醉机行机械通气,丙泊酚和维库溴铵维持麻醉。从三通喉罩操作孔置入纤支镜进行球囊扩张治疗气道狭窄。分别记录入室后（T0,基础值）、置入喉罩即刻（T1）、扩张开始前（T2）、扩张时（T3）、扩张结束后（T4）、术毕（T5）各时点的HR、SBP、DBP和SPO2。T1~T5时记录潮气量（VT）、气道峰压（Ppeak）和呼气末二氧化碳分压（PETCO2）。结果 置入喉罩过程中患者SBP、DBP、HR较T0有小幅降低（P〈0.05）。喉罩控制通气后,各时点SPO2较T0均有显著改善（P〈0.05）。在扩张进行时,Ppeak轻微升高,均维持在25 cmH2O以下。全部患者均于术后8 min内清醒拔除喉罩;操作时间21~40 min。结论经三通喉罩行全麻下球囊扩张治疗气道狭窄,麻醉效果良好,术后并发症少。【Objective】To explore the advantage of three-way laryngeal mask in balloon dilatation for the patients of airway stenosis under general anesthesia.【Methods】Sixty,ASAⅠorⅡpatients of both sexes（17 male,43 female） aged 16~68 yr,weighing 38~82 kg underwent balloon dilatation under general anesthesia from February to May 2011 in shanghai pulmonary hospital.The three-way laryngeal mask was inserted after induction of anesthesia which was maintained with propofol and vecuronium,the patients were mechanically ventilated.The fiberoptic bronchoscope was inserted into the operation hole of three-way laryngeal mask for balloon dilatation.HR,SBP,DBP and SPO2 were recorded respectively before anesthesia（T0）,the time when inserting laryngeal mask（T1）,before dilatation（T2）,the time of dilatation（T3）,after dilatation（T4） and after operation（T5）.VT,Ppeak and PETCO2 were recorded at T1~T5.【Results】As compared with T0,HR,SBP,DBP lowed lightly when inserting laryngeal mask（P 0.05） and SPO2 was improved significantly when ventilated with the three-way laryngeal mask（P 0.05）.Ppeak of all patients increased lightly at the time of dilatation,below 25 cmH2 O.All the patients emerged from anesthesia and the laryngeal mask were removed within 8min after operation.The operation time was 21~40 min,no aspiration,obvious gastrointestinal inflation,and laryngeal injury occurred.【Conclusions】The effect of airway management in balloon dilatation using three-way laryngeal mask under general anesthesia is profitable.

关 键 词：喉罩 气道狭窄 球囊扩张 

分 类 号：R614.24[医药卫生—麻醉学]