不同充气量Supreme喉罩在妇科腹腔镜手术气道管理的研究  

Research on Different Cuff Inflating Volume for LMA Supreme in Gynecologic Laparoscopic Surgery

作　　者：冯洁华[1] 魏宏[1] 李朝阳[1] 张鹏[1] 张杰[1] 罗晓敏[1] 

机构地区：[1]深圳市南山区人民医院麻醉科,深圳518052

出　　处：《中国现代手术学杂志》2016年第6期460-464,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨不同充气量Supreme喉罩在妇科腹腔镜手术气道管理的效果。方法选择2016年1～7月全身麻醉下行择期妇科腹腔镜手术患者80例,随机分为四组,通气罩内分别予不同充气容量：A组15 ml,B组20 ml,C组25 ml,D组30 ml。记录所有患者喉罩置入情况,观察不同通气罩充气容量下喉罩成功置入后2 min（T0）、气腹并头低位后5 min（T）两个时段的通气罩内压（intracuff pressure,ICP）、口咽部漏气压（oropharyngeal leak pressure,OLP）和对应气道峰压Ppeak。比较术后咽喉部并发症情况。结果组间T0和T时点OLP、Ppeak比较,差异均无统计学意义（P〉0.05）,而四组间T0时和T时多重ICP比较有统计学差异,B组高于A组,C组明显高于B组,D组明显高于C组（P〈0.05）。组内与T0时比较,各组T时ICP、OLP均降低,而Ppeak升高,差异均有统计学意义（P〈0.001）。在T0时及T时点OLP均高于对应的Ppeak,未发生漏气。从A组到D组,随着充气量增加,并发症发生率有增加趋势,组间并发症持续时间比较有统计学差异（P〈0.01）。各组术中均有少量反流液量,均未发生误吸。结论 3号SLMA通气罩充气量15 ml即可满足妇科腹腔镜手术的气道管理,围术期咽喉部并发症发生率低,持续时间短,值得临床借鉴。Objective To investigate the effect of different cuff inflating volume for LMA Supreme in gynecologic laparoscopic surgery. Methods Eighty patients underwent gynecologic laparoscopic surgery from January to July 2016 were enrolled. After general anesthesia 3 # LMA Supreme were placed in all patients. 80 cases were randomly divided into four groups and were offered different cuff inflating volume：the cuff inflating volume was 15 ml in group A,20 ml in group B,25 ml in group C and 30 ml in group D.The intracuff pressure（ ICP）,oropharyngeal leak pressure（ OLP） and Ppeak were recorded at the time point of 2 min after insertion（ T0） and 5 min after pneumoperitoneum and trendelenburg position（ T）.The postoperative complications of throat were compared. Results There was no statistical difference in OLP and Ppeak at both T0 and T among four groups（ P〉0. 05）. But ICP appeared statistical difference at both T0 and T in the four group comparison,the ICP was increasing progressively in group A,B,C and D（ P〈0. 05）. In intra-group comparison： Compare to T0,both the ICP and OLP were lower,and Ppeak was higher at T time point among all groups,the differences were statistical significance（ P〈0. 05）. The OLP was higher than Ppeak at T0 and T,there was no air leakage occurred. As the cuff inflating volume increased,the incidence of postoperative complication showed an increasing trend,but only the duration ofthroat complication revealed statistical difference among four groups（ P〈0. 01）. In each group,there was little reflux,but no aspiration. Conclusion The cuff inflating volume of 15 ml for LMA Supreme is feasible with low incidence and short duration of postoperative throat complications in gynecological laparoscopic operation.

关 键 词：喉罩 通气罩容量 通气罩内压 腹腔镜检查 妇科外科手术 

分 类 号：R614.2[医药卫生—麻醉学]