食管引流型喉罩在俯卧位经皮肾镜碎石全麻手术中的安全性  

Safety of LMA-ProSeal in percutaneous nephrolithotripsy in the prone position

作　　者：霍斌 马少斌 薛兴[1] 张艳[1] Huo Bin;Ma Shao-bin;Xue Xing;Zhang Yan(Day Surgery Center,The First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Anesthesiology,The First Hospital of Lanzhou University Branch of Linxia,Linxia 731100,Gansu,China)

机构地区：[1]兰州大学第一医院日间手术中心,甘肃兰州730000 [2]兰州大学第一医院临夏县分院麻醉科,甘肃临夏731100

出　　处：《兰州大学学报（医学版）》2022年第9期38-40,46,共4页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的探讨食管引流型喉罩(PLMA)在全身麻醉经皮肾镜碎石手术中的应用。方法80例经皮肾镜碎石术患者随机分为PLMA组、加强型气管插管(RTT)组,分别观察2组患者诱导前(T_(0))、置入PLMA或RTT即刻(T_(1))、置入后1 min(T_(2))、置入后5 min(T_(3))、截石位改俯卧位后1 min(T_(4))、拔除时(T_(5))、拔除后15 min(T_(6))心率和平均动脉压的变化。结果RTT组术中平均动脉压、心率变化大,在T_(1)、T_(2)、T_(5)2组患者差异有统计学意义(P<0.05)。PLMA组俯卧位前后的气道峰值压力均小于相应的喉罩气道密封压力。2组患者术中均无低氧血症的发生。在苏醒期内,PLMA组呛咳、躁动以及术后咽痛、声嘶、低氧血症明显低于RTT组(P<0.05)。结论在全麻管理中PLMA相对于RTT,在维持呼吸功能的同时,减少了围术期循环的波动,降低了术后呼吸道并发症的发生,可以有效地用于经皮肾镜碎石手术。Objective To explore the application of the ProSeal laryngeal mask airway(PLMA)in percutaneous nephrolithotripsy under general anesthesia.Methods 80 patients undergoing percutaneous nephrolithotripsy were randomly divided into the PLMA group and the reinforced tracheal tube(RTT)group.The changes in the heart rate and mean arterial pressure were observed before the induction of anesthesia(T_(0)),immediately(T_(1)),1 min(T_(2)),5 min(T_(3))after placement of PLMA or RTT,1 min after prone positioning(T_(4)),immediately(T_(5))and 15 min(T_(6))after extubation.Results There was significant difference in T_(1),T_(2) and T_(5) between the PLMA group and the RTT group(P<0.05).In the PLMA group,the peak airway pressure before and after the prone position was smaller than the corresponding airway sealing pressure.No hypoxemia appeared in both groups.During the recovery period,the cases of cough,restlessness,postoperative sore throat,hoarseness and hypoxemia in the PLMA group were significantly fewer than those in the RTT group(P<0.05),there was no significant difference in nausea and vomiting(P>0.05).Conclusion PLMA compared with RTT,can maintain respiratory function,reduce the fluctuation of perioperative circulation and reduce the occurrence of postoperative respiratory complications,and therefore can be effectively used in percutaneous nephrolithotripsy.

关 键 词：食管引流型喉罩 气管插管 俯卧位 经皮肾镜碎石术 

分 类 号：R654.1[医药卫生—外科学]