三种喉罩在妇科腹腔镜手术气道管理中的应用效果  

Application of Three Kinds of Laryngeal Mask in Air Way Management of Gynecological Laparoscopic Surgery

作　　者：秦蕊[1] 赵娜 郭蕾 陈易[1] 倪新莉[1] 陈进华[1] QIN Rui;ZHAO Na;GUO Lei;CHEN Yi;NI Xinli;CHEN Jinhua(Department of Anesthesiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Obstetrics and Gynecology,Ningxia Children's Hospital,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院麻醉科,银川750004 [2]宁夏回族自治区儿童医院妇产科,银川750004

出　　处：《宁夏医科大学学报》2023年第1期33-36,共4页Journal of Ningxia Medical University

基　　金：宁夏回族自治区重点研发计划项目(2021BEG03039)。

摘　　要：目的比较单腔喉罩、可插管双腔喉罩及多腔可转动喉罩在妇科腹腔镜手术气道管理中的应用效果。方法选取择期行妇科腹腔镜手术患者150例,ASA分级Ⅰ~Ⅱ级,年龄18~60岁,随机分为三组,即单腔喉罩组(A组)、可插管双腔喉罩组(B组)和多腔可转动喉罩组(C组),每组50例。记录气道密闭压、麻醉时间、喉罩置入和拔除时间、首次置入成功率、麻醉中调整率、中转气管插管率、严重漏气率及并发症发生率(喉罩粘血、低氧血症、咽喉痛、恶心呕吐、声音嘶哑及吞咽困难)、术中气道峰压(Ppeak)及呼气末二氧化碳分压(PetCO_(2))(麻醉诱导后1 min;气腹后1 min;头低位后1 min;气腹后30 min和60 min、停气腹后1 min)。结果三组患者气道密闭压测量结果差异有统计学意义(P<0.001),且B组优于A组及C组(P<0.001;P=0.009)。三组患者Ppeak及PetCO_(2)在不同时间点组间差异均无统计学意义(P均>0.05)。喉罩置入和拔除时间、首次置入成功率、麻醉中调整率、中转气管插管率、严重漏气率及并发症发生率(喉罩粘血、低氧血症、咽喉痛、恶心呕吐、声音嘶哑及吞咽困难)差异均无统计学意义(P均>0.05)。结论单腔喉罩、可插管双腔喉罩及多腔可转动喉罩均可安全用于妇科腹腔镜手术的气道管理,其中可插管双腔喉罩气道密闭性更优。Objective To compare the application of single-cavity laryngeal mask,intubatable double-cavity laryngeal mask and multi-cavity rotatable laryngeal mask in airway management of gynecological laparoscopic surgery.Methods A total of 150 patients(ASA gradeⅠ-Ⅱ,18-60 years old)undergoing elective gynecological laparoscopic surgery were randomly divided into three groups:single-cavity laryngeal mask(group A),intubatable double-cavity laryngeal mask(group B)and multi-cavity rotatable laryngeal mask(group C),with 50 patients in each group.Airway pressure,anesthesia time,laryngeal mask placement and removal time,success rate of first implantation,adjustment rate during anesthesia,rate of transtracheal intubation,rate of severe air leakage and incidence of complications(laryngeal mask adhesion,hypoxemia,sore throat,nausea and vomiting,hoarseness and dysphagia)were recorded.Intraoperative airway peak pressure(Ppeak)and end-expiratory partial carbon dioxide pressure(PetCO_(2))(1 min after anesthesia induction;1 min after pneumoperitoneum;1 min after head low;30 min after pneumoperitoneum,60 min after pneumoperitoneum,1 min after stopping pneumoperitoneum).Results The results of airway pressure measurement were statistically different among the three groups(P<0.001),and group B was better than group A and C(P<0.001;P=0.009).There were no statistically significant differences in Ppeak and PetCO2 between the three groups at different time points(P all>0.05).There were no statistically significant differences in the time of laryngeal mask implantation and removal,success rate of first laryngeal mask implantation,adjustment rate during anesthesia,rate of endotracheal intubation during transfer,rate of severe air leakage and incidence of complications(laryngeal mask adhesion,hypoxemia,sore throat,nausea and vomiting,hoarseness and dysphagia)(P all>0.05).Conclusion Single-lumen laryngeal mask,intubatable double-lumen laryngeal mask and multi-lumen rotatable laryngeal mask can be safely used for airway management in gynecological

关 键 词：喉罩 妇科 腹腔镜手术 气道管理 麻醉 

分 类 号：R713[医药卫生—妇产科学] R614.1[医药卫生—临床医学]