喉罩联合支气管封堵器在小儿胸腔镜肺叶切除术中的应用  

Laryngeal mask airway with endobronchial blocker for one-lung ventilation in children undergoing video-assisted thoracoscopic lobectomy

作　　者：李晓玲[1] 袁柳青 LI Xiao-ling;YUAN Liu-qing(Department of Anesthesiology,the First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第一附属医院麻醉科,江西赣州341000

出　　处：《赣南医学院学报》2021年第10期994-997,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨喉罩支气管封堵器在小儿胸腔镜肺叶切除术中的应用。方法:选择拟行胸腔镜下肺叶切除术的患儿60例,随机分为喉罩组(观察组)和气管插管组(对照组),各30例。插管成功后采用压力控制模式机械通气。记录总插管时间和术中定位次数,观察单肺通气前(T0)和单肺通气45 min(T2)的呼吸力学参数值[潮气量(Vt)、肺顺应性(CL)及呼气末二氧化碳分压(PETCO2)],测量插管前后的血压、心率,记录术后并发症(如低氧血症、术后肺不张、咽喉痛、声嘶及声带损伤等)的发生情况。结果:观察组总插管时间明显短于对照组(P<0.01)。T2时刻,观察组潮气量和肺顺应性均高于对照组,但PETCO2明显低于对照组(P<0.05)。观察组插管前后血压更平稳,且高碳酸血症发生率明显低于对照组(P<0.05)。结论:在小儿胸腔镜肺叶切除术中,喉罩联合支气管封堵器单肺通气可增加吸入潮气量,改善通气,降低高碳酸血症发生率,但不增加并发症的发生率。Objective:To investigate the effects of laryngeal mask airway(LMA)with endobronchial blocker forone-lung ventilation in children undergoing video-assisted thoracoscopic lobectomy.Methods:Sixty children undergoing thoraco⁃scopic surgery were randomly divided into LMA group(n=30)and control group(n=30).After intubation,children were ventilated with pressure-controlled mode.The total intubation time and position time were recorded.Respiratory mechanics were recorded before the beginning of one-lung ventilation(T0)and 45 min after one-lung ventilation(T2),and hemodynamic parameters were also recorded.Meanwhile,postoperative side effects were also recorded.Results:The total intubation time was shorter in the experimental group(P<0.01).At T2,tidal volumes and compliance of lung were significantly increased in LMA group than that in the control group(P<0.05),while PETCO2 was significantly lower in LMA group than that in the control group(P<0.05).The incidence of hypercarbia was higher in LMA group com⁃pared to the control group.Conclusion:The LMA with endobronchial blocker for one-lung ventilation could increase tid⁃al volume,improve oxygenation and reduce incidence of hypercarbia in children.

关 键 词：喉罩 支气管封堵器 肺通气 儿童 胸腔镜 肺叶切除术 

分 类 号：R614[医药卫生—麻醉学]