可视喉罩联合支气管封堵器降低胸腔镜肺切除术后咽喉疼痛发生率  

Optical laryngeal mask in combination with bronchial blocker reducing the incidence of sore throat after video-assisted pneumonectomy

作　　者：王嘉锋 赵珍珍 包睿 朱文忠 卞金俊 WANG Jiafeng;ZHAO Zhenzhen;BAO Rui;ZHU Wenzhong;BIAN Jinjun(Faculty of Anesthesiology,Changhai Hospital,Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院(上海长海医院)麻醉学部,上海200433

出　　处：《上海医学》2022年第3期175-178,共4页Shanghai Medical Journal

基　　金：上海市“医苑新星”青年医学人才培养资助计划(沪卫人事[2020]87号)。

摘　　要：目的探索SafeLM新型可视喉罩联合支气管封堵器在胸腔镜辅助下肺切除术中的应用价值。方法回顾性分析2021年1—9月间行胸腔镜辅助下肺切除术并接受可视喉罩插管的患者20例(SafeLM组),将同时期在双腔气管导管插管(DLT)下接受相同手术,性别、年龄(±3岁)、手术侧相匹配的20例患者作为配对对照(DLT组)。比较两组间术后咽喉痛、声音嘶哑、置管时间、置管后血压或心率波动幅度>15%、单肺通气成功率、肺萎陷程度,以及术中低氧血症的发生次数。结果两组间患者的性别构成、年龄、BMI、ASA分级、手术类型、麻醉与手术时间的差异均无统计学意义(P值均>0.05)。SafeLM组患者术后咽喉痛发生率(10%)显著低于DLT组(45%,P<0.01)。SafeLM组置管后心率或血压升高幅度>15%的发生率(10%)显著低于DLT组(40%,P<0.05),置管操作时间[(9.9±3.7)min]显著长于DLT组[(4.7±1.7)min,P<0.01]。两组间术后声音嘶哑发生率、单肺通气成功率和肺萎陷程度的差异均无统计学意义(P值均>0.05)。结论SafeLM可视喉罩联合支气管封堵器可有效应用于胸腔镜辅助下肺切除术的全身麻醉,可减少双腔气管导管插管引起的术后咽喉疼痛和气管插管引起的血流动力学紊乱。Objective To investigate the utilization of SafeLM optic laryngeal mask in combination with bronchial blocker in video-assisted pneumonectomy.Methods Patients who underwent video-assisted pneumonectomy under general anesthesia with SafeLM laryngeal mask from January to September 2021 were respectively analyzed(SafeLM group).Age(±3 years),sex and surgical position matched patients who underwent the same surgery using double-lumen tube(DLT)were selected as controls(DLT group).The incidence of sore throat,hoarseness,intubation time,changes of blood pressure and heart rate after intubation,successful rate of one-lung ventilation,degree of lung collapse and incidence of hypoxia during surgery were compared between the two groups.Results A total of 40 patients were enrolled in this study,with 20 patients in each group.There were no significant differences in the gender,age,BMI,ASA classification,type of surgery,duration of anesthesia or surgery between the 2 groups(all P>0.05).The incidence of sore throat in the SafeLM group was significantly lower than that in the DLT group(10%vs.45%,P<0.01).Less patients in SafeLM group had an increase of 15%in heart rate or blood pressure than DLT group(10%vs.40%,P<0.05);but the intubation time in the SafeLM group was significantly longer than that in the DLT group([9.9±3.7]min vs.[4.7±1.7]min,P<0.01).There were no significant differences in the incidence of hoarseness,incidence of successful one-lung ventilation or degree of lung collapse between the two groups(all P>0.05).Conclusion SafeLM laryngeal mask can be effectively used in general anesthesia for video-assisted pneumonectomy in combination with bronchial blocker.It can reduce the incidence of postoperative sore throat and changes in heart rate and blood pressure after intubation.

关 键 词：可视喉罩 支气管封堵器 单肺通气 双腔气管导管 胸腔镜辅助下肺切除术 

分 类 号：R614[医药卫生—麻醉学]