减小喉罩型号改善通气效果的临床观察  

Improvement effect of reduction of laryngeal mask airway size on laryngeal mask airway ventilation

作　　者：张风敏[1] 王华 孙苏娟 ZHANG Fengmin;WANG Hua;SUN Sujuan(Department of Anesthesiology,The Third Hospital of Shijiazhuang,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市第三医院麻醉科,050000

出　　处：《河北医药》2024年第7期1049-1051,1055,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20150879)。

摘　　要：目的探讨减小喉罩型号改善通气效果的临床观察。方法选取喉罩固定翼距门齿距离>3 cm的男性患者60例为研究对象,随机分为试验组和对照组,每组30例。比较试验组(3号喉罩)与对照组(4号喉罩)的通气优良率、FOB理想位置比例、气道峰压差及2组喉罩置入后的密封压、套囊内压、漏气率,比较2组喉罩远端与食道入口距离,观察2组喉罩拔出时带血丝情况,术后24 h咽部并发症发生情况(包括术后咽痛、声嘶)及咽痛持续时间。2组患者设置的呼吸参数相同。结果试验组喉罩置入后通气成功率、FOB理想位置置入比例及通气效果优良率提高,漏气率值降低,密封压值提高,喉罩远端距食道入口距离较对照组减小,术后咽部并发症发生率较对照组低,差异均有统计学意义(P<0.05)。结论对于喉罩固定翼距门齿距离>3 cm的患者,通过减小喉罩型号,使喉罩放置理想位置比例增加,通气优良率升高,漏气率降低,密封压值提高,咽部并发症降低,可改善喉罩通气效果,安全有效。Objective To explore the improvement effect of reduction of laryngeal mask airway(LMA)size on LMA ventilation.Methods A total of 60 male patients with the distance between LMA fixed wing and incisor teeth>3cm were randomly assigned into the experimental group(size 3 LMA)and the control group(size 4 LMA).The respiration parameters of the two groups were consistent;the aim was to compare ventilation excellent rate,ideal position ratio of fibreoptic bronchoscopy(FOB),airway peak-pressure,and the sealing pressure,cuff pressure and air leakage rate after LMA insertion,the distance from the far end of the LMA to the esophagus entrance,blood situation when LMA pulled out,24-h pharyngeal complications(postoperative sore throat[POST],hoarseness),duration of sore throat.Results After LMA placement,the experimental group were suprior to the control groups for ventilation successful rate,ideal position ratio of FOB,ventilation effect,air leakage rate,sealing pressure value,the distance from the far end of the LMA to the esophagus entrance,as well as postoperative pharyngeal complications(all P<0.05).Conclusion For patients with the distance between LMA fixed wing and incisor teeth>3cm,the reduction of LMA size can increase the proportion of the ideal position ratio of LMA,increase the ventilation excellent rate,reduce the air leakage rate,increase the sealing pressure value,and reduce the pharyngeal complications,thereby improving the LMA ventilation,with safety and effectiveness.

关 键 词：全身麻醉 SUPREME喉罩 更换型号 密封压 漏气率值 

分 类 号：R614[医药卫生—麻醉学]