Supreme LMA非持续放置胃管对腹腔镜胆囊切除术通气效果的影响  

The clinical observation of the ventilation effect of non-persistent gastric tube placement in patients undergoing laparoscopic cholecystectomy using supreme laryngeal mask airway

作　　者：左琛[1] 陆良愿 Zuo Chen;Lu Liangyuan(Aerospace Central Hospital,Beijing 100049)

机构地区：[1]航天中心医院,北京100049

出　　处：《中国现代医药杂志》2017年第7期13-16,共4页Modern Medicine Journal of China

摘　　要：目的观察Supreme LMA用于腹腔镜胆囊切除术时放置胃管与否对术中气道管理效果的影响。方法择期全麻下行腹腔镜胆囊切除术患者120例,ASAⅠ~Ⅱ级,Mallampati分级Ⅰ~Ⅲ级,年龄28~66岁,体重52~95kg。按随机数字表法将所有患者分成A、B、C三组,每组40例。常规全麻诱导置入喉罩后,A组患者通过Supreme喉罩的引流管放入胃管,持续引流至术毕。B组采取相同方法放置胃管,手动充分引流后即拔出胃管。C组为放置喉罩后不给予放置胃管。记录手术时间、麻醉时间、拔出喉罩时间(术毕至拔出喉罩时间),使用p H试纸测定使用后的喉罩尖端背侧及腹侧p H值,记录术中喉罩漏气及返流发生率,以及术后12h咽痛、吞咽困难和声音嘶哑等不良反应的发生情况。结果 A组患者的喉罩漏气发生率和B、C两组比较有明显统计学差异(P<0.05)。B组患者喉罩内返流、咽痛发生率也较A、C两组发生率低(P<0.05),B、C两组之间发生率有不同,但统计学比较无明显差异(P>0.05)。结论对于腹腔镜胆囊手术患者,Supreme喉罩使用过程中非持续放置胃管,可以显著降低喉罩漏气发生率、返流发生率和咽痛发生率。Objective To observe the ventilation effect of non-persistent gastric tube placement in patients undergoing laparoscopic cholecystectomy using supreme laryngeal mask airway(LMA).Methods One hundred and twenty ASAⅠorⅡpatients of both sexes aged28~66y weighting52~95kg undergoing elective laparoscopic surgery were randomized to3groups:group A,group B and group C(40cases in each group).In group A,the gastric tube was inserted through the drain tube of SLMA,continuous drainage until the end of surgery.In group B,patients were used the same method to insert gastric tube,but pulling out the tube in complete drainage of gastric juice.In group C,the patients were not given indwelling gastric tube.The operation time,anesthesia time and the time of pulling out the SLMA(from the end of the operation to the time of pulling out the SLMA)were recorded.Used pH test paper to determine the value of the dorsal and ventral side of the tip of the posterior SLMA and recorded the value.Recorded the incidence of laryngeal mask airway leakage,the incidence of oral reflux,and the occurrence of adverse reaction of12hours of sore throat,dysphagia and hoarseness after operation.Results There were significantly statistical differences among group A and B and C in the incidence of laryngeal mask airway leakage(P<0.05).The incidence of sore throat,and the incidence rate in the regurgitation of the oral cavity in group B was lower than group A and C(P<0.05).The incidence between group B and C were different,but there was no significant difference between the two groups(P>0.05).Conclusion For the patients with laparoscopic cholecystectomy,the use of non-persistent gastric tube drainage in gastric juice in using SLMA can significantly reduce the incidence of laryngeal mask leakage,reflux and sore throat.

关 键 词：SUPREME喉罩 胃管 加速康复外科 

分 类 号：R657.4[医药卫生—外科学]