双气道喉罩的研制及临床应用观察  

Development and Observation Clinical Application of the Double Laryngeal Mask Airway

作　　者：付学明[1] 安振平[1] 熊伟[1] 左星[1] 蒋思源[1] 彭清臻[1] 厉银平[1] 

机构地区：[1]湖北省孝感市中心医院麻醉科,432100

出　　处：《中华全科医学》2013年第11期1698-1700,共3页Chinese Journal of General Practice

摘　　要：目的探讨双气道喉罩通气全麻下施行纤支镜检查和治疗的可行性和安全性。方法选择80例患者为研究对象,均自愿在双气道喉罩通气全麻下行纤支镜检查和治疗。快速麻醉诱导下插入双气道喉罩,将双气道喉罩的主导管接呼吸机控制呼吸,静脉泵注异丙酚和瑞芬太尼维持全麻,间断追加爱可松维持肌松。纤支镜检查时,打开封闭帽的橡胶盖体,纤支镜经中央孔进入气道,进行检查和治疗。分别记录T0、T1、T2、T3、T4、T5时的MAP、HR、SPO2、Ppeak及P Et CO2值,观察镜检时患者发生呛咳、体动等不良事件以及纤支镜通过声门的难易程度,调查术后患者有无术中知晓和咽痛以及镜检医生和患者的满意度。结果纤支镜与双气道喉罩密封环密封良好,患者在镜检过程中未出现体动和呛咳,纤支镜容易通过声门。患者无咽痛和术中知晓,患者和内镜医生对双气道喉罩通气麻醉效果的满意度为100%。麻醉期间,T1、T2、T3、T4时点的MAP、HR之间比较差异均无统计学意义(P>0.05),T1、T2、T3、T4和T5时的SPO2均比T0时升高,在整个机械通气过程中Ppeak、P Et CO2均无明显变化,差异无统计学意义(P>0.05)。结论双气道喉罩设计合理,使用方便,双气道喉罩的研制成功解决了纤支镜检查和麻醉管理共用一个气道的问题,两根独立的管道不影响纤支镜检查过程中呼吸道的管理,成功地解除了纤支镜检查和治疗过程中的一些困难和风险,是一种安全、有效、副作用和并发症较小的技术方案。Objective To investigate the feasibility and safety of treatment and examination of bronchoscopy with the double laryngeal mask airway under general anesthesia. Methods 80 cases for the study were treated and examined voluntarily with the double laryngeal mask airway under general anesthesia. After anesthesia induction the leading pipe connext ventilator to control breathing, i. v. of Penehyclidine hydrochloride and Fentanyl maintain anesthesia, of Rocuronium maintain muscle loose, SBP, DBP, HR,SPO2, Ppeak, PE, CO2 at the time of T0,T1 ,T2, T3, T4,T5 were recorded. To ask if there was sore throat and the satisfac-tion of the intubation process when all cases were fully conscious. Results Bronchoscopy and the treatment went well,there were not sore throat and it was satisfactory 100%. During anesthesia there were not statistically different（ P 〉 0.05 ） between Tl ,T2, T3, T4 and MAP, HR. The SPO2 value was higher at Tl , T2, T3, T4, T5 than To, Ppeak ,PEtCO2 value were not statistically different （ P 〉 0.05 ） either. Conclusion Application of bronchoscopy combined self-made connective combined self-made connective tube with improved laryngeal mask airway was one of successful resolution of difficulties breathing problem when the testing and anesthesia share in one airway, so it was safe and feasible apparatus.

关 键 词：双气道喉罩 纤支镜 诊疗 

分 类 号：R614[医药卫生—麻醉学] R768.1[医药卫生—外科学]