可调节型提下颌麻醉面罩在自主通气全身麻醉中的应用  

The chin-lift mask used in spontaneous ventilation general anesthesia

作　　者：谢淑华[1] 魏颖[1] 耿立成[1] 

机构地区：[1]天津市人民医院麻醉科,300121

出　　处：《国际麻醉学与复苏杂志》2017年第8期705-708,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的对比可调节型提下颌麻醉面罩与喉罩在自主通气全身麻醉中的应用。方法选择行疝修补手术、妇科外阴手术、宫腔镜手术、肛门痔瘘手术等自主通气全身麻醉手术患者100例，按随机数字表法分为面罩组和喉罩组，每组50例。记录两组患者麻醉诱导前（T0）、放置面罩或喉罩前1min（T1）、放置面罩或喉罩即刻（T2）、切皮时（T3）、拔除面罩或喉罩前1min（T4）、拔除面罩或喉罩即刻（T5）时的MAP、HR、吸气峰压（peak inspiratory pressure, PIP）、PETCO2、SpO2等，记录插入喉罩或可调节型提下颌麻醉面罩的时间和一次成功率，记录患者清醒时间和改良Aldrete评分达到9分时间，观察术后24h内患者的并发症。结果可调节型提下颌麻醉面罩与喉罩在两组患者中均成功置入，面罩组各时点间HR和MAP差异均无统计学意义。喉罩组T2时点HR和MAP明显高于T1、T3时点（P〈0．05），B时点HR和MAP明显高于T0、T4时点（P〈0．05）；SpO2、PETO2、PIP、患者苏醒时间以及改良Aldrete评分达到9分时间在两组之间差异无统计学意义；支气管痉挛、术后咽痛发生率两组之间差异无统计学意义。结论可调节型提下颌麻醉面罩在自主通气全身麻醉中置入成功率较高，术后并发症较少，是一种安全、有效的呼吸道管理工具。Objective Comparing the function of the chin-lift mask with laryngeal mask in spontaneous ventilation general anesthesia. Methods One hundred patients who performed operations such as herniorrhaphy, genital surgery of women, hysteroscopy and anus hemorrhoids fistula operation were divided into two groups with the random number table method, group M （the chin-lift mask group）, group L （laryngeal mask group）. MAP, HR, peak inspiratory pressure （PIP）, PETCO2 and SpO2 were recorded at different time points： before anesthesia （T0）, 1 min before placing the chin-lift mask or laryngeal mask （T1）, immediately after placing the chin-lift mask or laryngeal mask （T2）, skin incision （T3）, pulling out the chin-lift mask or laryngeal mask （T4）. At the same time, the complications of postoperative patients were observed. Results The chin-lift mask and laryngeal mask were all successful placement in the patients. HR and MAP have no significant difference between different time points in M group, whereas HR and MAP in T2 points are much higher than HR and MAP of T1 and T3 points （P〈0.05）. HR and MAP in T5 points are much higher than To and T4 points （P〈0.05） in L group. SpO2, PETCO2, PIP, patients waking up time and the time of improvement Aldrete Scores of 9 have no significant difference between two groups. Patients with bronchospasm and Postoperative sore throat have no significant difference between two groups. Conclusions The chin-lift mask which characterized by high successful rate in clinical application and fewer complications post-operation, is a safe and effective respiratory tract management tool used for spontaneous ventilation general anesthesia.

关 键 词：可调节型提下颌麻醉面罩 喉罩 麻醉 全身 

分 类 号：R614.2[医药卫生—麻醉学]