双气道喉管用于中心气道狭窄气管支架置入术的效果  

Effect of double airway larynx on stent implantation for central airway stenosis

作　　者：侯铁柱 张加强 代彦文 童明军 代山 吴敏 刘胜群 HOU Tiezhu;ZHANG Jiaqiang;DAI Yanwen;TONG Mingjun;DAI Shan;WU Min;LIU Shengqun(Department of Anesthesiology and Perioperative Medicine,People’s Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院麻醉与围术期医学科,450003

出　　处：《临床麻醉学杂志》2021年第10期1048-1051,共4页Journal of Clinical Anesthesiology

基　　金：河南省医学科技攻关计划项目(201303173)。

摘　　要：目的评价双气道喉管用于中心气道狭窄气管支架置入术的效果。方法选择择期行中心气道狭窄气管支架置入术患者42例,男28例,女14例,年龄18-64岁,ASAⅡ或Ⅲ级。采用随机数字表法分为两组:双气道喉管组(D组)和普通喉罩组(C组),每组21例。麻醉诱导后,D组、C组分别置入双气道喉管和普通喉罩,行机械通气。记录麻醉诱导前(T_(1))、置入喉管/喉罩开始通气时(T_(2))、手术开始(T_(3))、支架置入时(T_(4))及术毕停止麻醉药后5 min(T_(5))的MAP、HR和SpO_(2)。分别于支架置入前和置入后抽取动脉血样行血气分析,记录pH值、PaO_(2)和PaCO_(2)。记录手术时间和支架置入调整例数。记录气管黏膜损伤、术后声嘶和术后咽痛的发生情况。结果T_(1)—T_(5)时两组MAP、HR和SpO_(2)差异无统计学意义。与C组比较,D组支架置入后pH值、PaO_(2)明显升高,PaCO_(2)明显降低,手术时间明显缩短,支架置入调整例数明显减少,气管黏膜损伤、术后声嘶和术后咽痛发生率明显降低(P<0.05)。结论双气道喉管用于中心气道狭窄气管支架置入术,可有效减少并发症的发生。Objective To evaluate the effect of double airway larynx on stent implantation for central airway stenosis.Methods Forty-two patients scheduled for elective stent implantation for central airway stenosis,28 males and 14 females,aged 18-64 years,ASA physical statusⅡorⅢ,were randomly divided into two groups(n=21 each)using a random number table method:double airway larynx group(group D)and common larynx group(group C).After anesthesia induction,laryngeal mask or double airway larynx were placed,mechanical ventilation was performed,and tracheoscopy was used to locate or guide stent implantation.MAP,HR and SpO_(2) were recorded before anesthesia induction(T_(1)),at the beginning of laryngeal mask/larynx ventilation(T_(2)),at the beginning of surgery(T_(3)),at the time of stent implantation(T_(4)),and 5 minutes after anesthesia cessation(T_(5)).Arterial blood samples were extracted before and after stent implantation for blood gas analysis,and pH,PaO_(2) and PaCO_(2) were recorded.Operation time and number of stent adjustment cases were recorded.The occurrence of tracheal mucosa injury,postoperative hoarseness and postoperative pharyngeal pain were recorded.Results There was no significant difference between group D and group C in MAP,HR,SpO_(2) at T_(1)-T_(5).Compared with group C,the pH value and PaO_(2) in group D were significantly increased immediately after stent implantation,PaCO_(2) was significantly decreased,the operation time was significantly shortened,the number of stent implantation adjustment cases was significantly reduced,and the incidence of trachea mucosal injury,postoperative hoarsing and postoperative sore throat were significantly decreased(P<0.05).Conclusion Double airway larynx is feasible for central airway stenosis tracheal stent implantation,which effectively reduces complications.

关 键 词：双气道喉管 中心气道狭窄 支架置入 

分 类 号：R614[医药卫生—麻醉学]