气道峰压法判断喉罩通气效果的初步探讨  

Preliminary study on the peak airway pressure in estimating the effect of laryngeal mask airway ventilation

作　　者：周炜[1] 杨芳芳[1] 郭文俊[1] 金孝岠[1] 

机构地区：[1]皖南医学院第一附属医院弋矶山医院麻醉科,安徽芜湖241001

出　　处：《皖南医学院学报》2017年第2期159-161,共3页Journal of Wannan Medical College

摘　　要：目的:初步探讨全身麻醉过程中利用面罩机械通气和喉罩机械通气时气道峰压的差值判断喉罩通气效果的正确率和可行性。方法:180例择期全身麻醉下接受妇科手术患者,全身麻醉诱导后,在机械通气容量控制模式(VCV)下行常规面罩通气给氧去氮。待肌松药起效后置入Supreme喉罩(SLMA),按照随机顺序先后使用以下两种方法判断通气效果。压力差法(P法):在相同的通气参数下行机械通气,记录面罩通气时的气道峰压P1和机械通气时的气道峰压P2,得出P2-P1的差值判断喉罩通气效果。纤支镜法(F法):应用纤支镜检查SLMA对位情况判断喉罩通气效果。另外,分别记录两种方法的总耗时,术后喉罩相关并发症的发生情况。结果:相比纤支镜法,压力差法判断喉罩通气效果的正确率无统计学意义,而所需时间明显减少。结论:气道峰压差值法可有效判断喉罩通气效果,且更加简单、快速。Objective： To assess the accuracy and feasibility by the different values of peak airway pressure under mask ventilation and laryngeal mask ventilation in estimating the effect of laryngeal mask airway ventilation.Methods：180 patients undergoing elective gynecological surgery under general anesthesia were given mask mechanical ventilation in volume control （VCV） mode after anesthesia induction,followed by insertion of Supreme laryngeal mask （SLMA） after obtaining muscle relaxant effect.Ventilation effect by laryngeal mask airway was estimated as：①Pressure difference（P method）,patients were given mechanical ventilation in the same ventilation parameter.The value of peak airway pressure was recorded in mask ventilation （P1） and laryngeal mask ventilation （P2）,and the difference P2-P1 was calculated to estimate the ventilation effect of laryngeal mask airways;and ②Fiberoptic assessment of LMA position（F method） for estimation of the effect of laryngeal mask airy ventilation.The total time consumption and postoperative complications were maintained for the two methods.Results：The two methods were not significantly different concerning the ventilation accuracy,yet P method required less time in the procedure.Conclusion：Peak airway pressure difference may be a simpler and quicker approach to assessment of the ventilation effect of laryngeal mask airway.

关 键 词：喉罩 麻醉 气道峰压 

分 类 号：R614.2[医药卫生—麻醉学]