气管导管对比可弯曲喉罩在小儿腺样体切除术中的应用  

Retrospective study of flexible laryngeal mask airway for adenoidectomies in children compared with intubation

作　　者：赵梨园 王媛[1] 赵增晓 徐磊[1] 陈三冬 贾英萍 ZHAO Li-yuan;WANG Yuan;ZHAO Zeng-xiao;XU Lei;CHEN San-dong;JIA Ying-ping(Department of Anesthesiology and Perioperative Medicine,Childrens Hospital Affiliated of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院麻醉与围术期医学科,郑州450000

出　　处：《医药论坛杂志》2021年第1期25-28,共4页Journal of Medical Forum

基　　金：河南省医学科技攻关计划项目(2018020653);郑州市科技发展计划(20150171)。

摘　　要：目的回顾性研究与气管导管对比,可弯曲喉罩在小儿腺样体切除手术中的安全性、有效性和可行性。方法查询本院2018年1月至2019年12月所有行择期低温等离子腺样体切除术的患儿记录。2018年1月至12月为ETT组,2019年1月至12月为F-LMA组。记录患儿的一般情况。记录麻醉诱导时间、手术时间、是否由F-LMA更换为ETT及原因、术后不良反应的发生情况(呛咳、咽痛、喉痉挛、返流误吸、苏醒期躁动、继发性出血、再插管等),术后镇痛泵的使用情况、术后拔管时间、PACU停留时间、术后住院时间。并对外科医生进行问卷调查评估其满意度。结果共纳入3 598例,其中ETT组1 855例,F-LMA组1 743例。共有6例患儿术中由F-LMA更换为ETT。术后拔管时间(15.5±13.6)min和PACU停留时间(47.9±12.6)min,显著短于ETT组拔管时间[(28.5±12.2)min]和PACU停留时间[(70.1±17.7)min],F-LMA组PCIA人均按压次数显著减少(3 vs.9),术后发生呛咳、咽痛、苏醒期躁动的患儿明显减少,差异有统计学意义(P<0.05)。F-LMA组总不良反应发生(323例)明显低于ETT组(673例),差异有统计学意义(P<0.05)。结论 F-LMA用于小儿低温等离子腺样体切除术中可提供安全的气道管理,减少围术期不良反应的发生,提高患儿舒适度。Objective To evaluate the safety, effectiveness and feasibility of flexible laryngeal mask airway for adenoidectomies in children compared with intubation. Methods The medical records of all children who underwent elective low-temperature plasma adenoidectomies in our hospital from January 2018 to December 2019 were retrospectively reviewd. The ETT group is from January to December of 2018, and the F-LMA group is from January to December of 2019. Data collected included general characteristics, the time needed for induction of anesthesia, surgery itself, whether to change from F-LMA to ETT and its reasons, and postoperative complications(cough, sore throat, laryngospasm, reflux aspiration, restlessness, secondary bleeding, re-intubation, etc.), postoperative analgesia pump use, post-extubation time, PACU stay time, postoperative hospital stay. The surgeon’s satisfaction level was also evaluated by questionnaire. Results A total of 3598 patients were included, including 1855 patients in the ETT group and 1743 patients in the F-LMA group. Conversion from F-LMA to ETT was carried out in six patients. Compared with ETT group, the postoperative extubation time and PACU stay time, the number of PCIA per capita compressions, and the number of children with cough, sore throat, and restlessness during the wake period in F-LMA group were significantly reduced(P<0.05). The incidence of total postoperative complications in F-LMA group was significantly lower than that of ETT group(P<0.05). Conclusion F-LMA can provide safe airway management for pediatric adenoidectomies which can reduce the incidence of perioperative adverse reactions, and improve the comfort of children.

关 键 词：可弯曲喉罩 气管插管 腺样体切除术 小儿 回顾性研究 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]