支撑喉镜与喉罩引导电子支气管镜治疗中心气道狭窄的效果对比分析  

A comparative study on the treatment of central airway stenosis with supporting laryn-goscope and laryngeal mask guided electronic bronchoscopy

作　　者：李中燕[1] 王平飞[1] 陈耀华[1] 万绍恒[1] 胡筱[1] 王伟林 吴丹 唐章 Li Zhongyan;Wang Pingfei;Chen Yaohua;Wan Shaoheng;Hu Xiao;Wang Weilin;Wu Dan;Tang Zhang(Dazhou Central Hospital,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中心医院呼吸与危重症医学科,四川达州635000

出　　处：《医药前沿》2020年第28期19-21,共3页Journal of Frontiers of Medicine

基　　金：四川省卫生和计划生育委员会科研课题(17PJ028)。

摘　　要：目的:对比分析支撑喉镜与喉罩引导电子支气管镜治疗中心气道狭窄的效果,寻找治疗中心气道狭窄的最佳方法。方法:选取2016年1月—2018年12月达州市中心医院呼吸内科中重度中心气道狭窄(狭窄面积≥50%)40例患者,随机分为两组:观察组(n=20)在全麻支撑喉镜联合高频通气下,经电子支气管镜完成中心气道的微创手术;对照组(n=20)在全麻喉罩+电子支气管镜+呼吸机辅助通气完成与支撑喉镜组相同的手术。比较两组的总有效率、被动出镜次数、术中调整支撑喉镜/喉罩次数、术中最低氧饱和度及并发症情况。结果:观察组和对照组总有效率分别是95%、100%,差异无统计学意义(P>0.05);观察组术中被动出镜次数为1次、调整次数为0次,明显低于对照组(术中被动出镜次数为6次、调整次数为5次),差异有统计学意义(P<0.05)。观察组术中患者氧饱和度为(87.75±5.757)%,明显高于对照组(82.80±8.788)%,差异有统计学意义(P<0.05)。观察组并发症发生率为50%,对照组为40%,差异无统计学意义(P>0.05)。结论:支撑喉镜和喉罩均能引导电子支气管镜治疗中心气道狭窄,使用支撑喉镜引导术中被动出镜及需要调整的次数更少、术中患者氧饱和度更稳定,无严重并发症,值得临床应用。Objective To analysis the advantages and disadvantages of supporting laryngoscope and laryngeal mask guided electronic bronchoscope in the treatment of central airway stenosis,and to find the best method for the treatment of central airway stenosis.Methods A total of 40 patients with moderate to severe central airway stenosis(stenosis area≥50%)in the department of Respiratory Medicine of Dazhou Central Hospital from January 2016 to December 2018 were selected and randomly divided into two groups:Observation group(n=20)underwent minimally invasive surgery of central airway with general anesthesia supported laryngoscope combined with high-frequency ventilation through electronic bronchoscope;The control group(n=20)underwent the same surgery with a general anesthesia laryngeal mask airway+electronic bronchoscope+ventilator-assisted ventilation as the control group(n=20).The total effective rate,times of passive exposure,times of intraoperative adjustment of supporting laryngoscope/laryngeal mask airway,lowest oxygen saturation and complications were compared between the two groups.Results The total effective rates of the observation group and the control group were 95%and 100%respectively,and the difference was not statistically significant(P>0.05).In the observation group,the number of passive intraoperative exposures was 1 and the number of adjustments was 0,which was significantly lower than that in the control group(the number of passive intraoperative exposures was 6 and the number of adjustments was 5),with statistically significant difference(P<0.05).The oxygen saturation in the observation group was(87.75±5.757)%,which was significantly higher than that in the control group(82.80±8.788)%,and the difference was statistically significant(P<0.05).The complication rate was 50%in the observation group and 40%in the control group,and the difference was not statistically significant(P>0.05).Conclusion Both strut laryngoscope and laryngeal mask airway can guide electronic bronchoscopy in the treatment of central

关 键 词：支撑喉镜 喉罩 中心气道狭窄 

分 类 号：R768[医药卫生—耳鼻咽喉科]