新型双管喉罩与气管插管在胃食管反流射频消融术中的比较  

Comparison between novel double-tube laryngeal mask and endotracheal intubation in radiofrequency ablation for treating gastroesophageal reflux

作　　者：王馨悦 李炜 杨朝霞[3] 冉涛 Wang Xinyue;Li Wei;Yang Zhaoxia;Ran Tao(Deparment of Anesthesiology,The Second Affiliated Hospital of Chongqing Medical University;Department of Pain,Chongqing Traditional Chinese Medicine Hospital;Department of Gastroenterology,The Second Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第二医院麻醉科,重庆400010 [2]重庆市中医院疼痛科,重庆401120 [3]重庆医科大学附属第二医院消化内科,重庆400010

出　　处：《重庆医科大学学报》2021年第2期232-236,共5页Journal of Chongqing Medical University

摘　　要：目的:比较新型双管喉罩(laryngeal mask airway,LMA)与气管内插管(endotracheal tube,ETT)在成人胃食管反流(gastroesophageal reflux disease,GERD)全麻下行射频治疗中的安全性和有效性。方法:选择行胃食管反流射频消融治疗的患者30例,随机分为喉罩组(L组)和气管插管组(T组)。预氧后常规静脉麻醉诱导,插入LMA或ETT,术中维持合适的麻醉深度,记录射频导管成功置入时间,7个时点的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、脉氧饱和度(pulse oxygen saturation,SPO2)、呼气末二氧化碳分压(end-tidal carbon dioxide partial pressure,PetCO2)和气道压,手术时间,拔管/罩时间,内镜医师和患者满意度,反流误吸的发生率。使用SPSS 22.0软件进行资料统计分析,计量资料以均数±标准差(x±s)表示,重复测量数据组内比较采用重复测量的方差分析,组间比较采用t检验,计数资料以构成比或率表示。结果:L组射频导管成功置入时间明显短于T组[(22.1±4.3)s vs.(76.0±6.3)s,P=0.000],手术时间及术后拔管/罩时间短于T组,患者及内镜医师的满意度均优于T组,T1时间点ETT组的HR和MAP明显高于L组,T1、T2、T4时间点L组的气道压明显高于T组,2组患者通气氧合的差异无统计学意义,无反流误吸等不良事件发生。结论:LMA的使用除了具有操作简单、很好的气道密封功能及血流动力学稳定等特点以外,还能明显缩短GERD射频消融手术的时间,同时提升患者围术期舒适度及内镜医师的满意度,能有效而安全地替代ETT用于胃食管反流病的射频治疗手术。Objective:To compare the safety and efficacy of the novel double-tube laryngeal mask airway(LMA)and endotracheal tube(ETT)on Stretta radiofrequency ablation therapy under general anesthesia in patients with gastroesophageal reflux disease(GERD).Methods:A total of 30 patients with GERD treated by radiofrequency therapy under general anesthesia were randomly divided into the LMA group(L group)and the ETT group(T group).After preoxygenation,the routine intravenous anesthesia was performed,the LMA or ETT was inserted and the reasonable depth of anesthesia was maintained.The time of successful placement of the radiofrequency catheter,mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SPO2),end-tidal carbon dioxide partial pressure(PetCO2)and airway pressure at seven different time points,operation time,extubation or mask-removal time,the satisfaction of endoscopic physicians and patients,and the incidence of reflux aspiration were recorded.SPSS 22.0 was used to perform the data statistical analysis,x±s was used to demonstrate measurement data,repeated-measure variance analysis was used to perform the intergroup comparison of repeated-measure data,t-test was adopted for intergroup comparison and constituent ratio or constituent rate was used to demonstrate the numeration data.Results:In the L group,the successful placement time of radiofrequency catheter was significantly shorter than that in the T group(P<0.05)[(22.1±4.3)s vs.(76.0±6.3)s,P=0.000],the operation time and postoperative extubation time were shorter than those in the T group(P<0.05),the satisfaction score of patients and endoscopy doctors was better than that in the T group.The HR and MAP in the T group were significantly higher than those in the L group at T1 time point(P<0.05).The airway pressure in the L group was significantly higher than that in the T group at T1,T2 and T4 time point.There was no significant difference in ventilation oxygenation between the two groups,and no adverse events such as reflux and aspiration.Conclusion:No

关 键 词：双管喉罩 胃食管反流 射频消融 

分 类 号：R614.2[医药卫生—麻醉学]