可视化超声与纤支镜定位技术用于老年喉罩全麻手术的对比研究  

Clinical comparative study on visual ultrasound and fiberoptic bronchoscope applied in elderly patients undergoing general anesthesia

作　　者：龙小丽 凌钧渲 LONG Xiaoli;LING Junxuan(Department of Anesthesiology,Yongkang City Orthopaedic Hospital,Yongkang 321300,China)

机构地区：[1]永康市骨科医院麻醉科,浙江永康321300

出　　处：《全科医学临床与教育》2025年第3期230-233,共4页Clinical Education of General Practice

摘　　要：目的 比较可视化超声与纤支镜定位技术用于老年喉罩全麻手术的喉罩正常通气率及并发症发生情况。方法 选取永康市骨科医院行喉罩全麻手术的老年患者92例,根据不同的定位方法分为超声组(n=46)和纤支镜组(n=46),超声组采用可视化超声定位,纤支镜组采用纤支镜定位。比较两组通气情况、平均动脉压(MAP)、心率(HR)水平;术前、术后1 d的血清免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平及并发症发生率。结果 超声组的置入时间、调整后正常通气时间均短于纤支镜组(t分别=5.63、6.20,P均<0.05);喉罩插入后即刻(T_(2))、插入后3 min(T_(3))、拔除时(T_(4))、拔除后即刻(T_(5))、拔除后3 min(T_(6))时,超声组MAP、HR水平均低于纤支镜组(t分别=7.82、9.36、5.22、6.20、8.46;8.64、6.32、8.10、7.69、8.63,P均<0.05);术后1 d,超声组血清IgM、IgA、IgG水平高于纤支镜组(t分别=12.84、5.80、4.19,P均<0.05);超声组并发症发生率低于纤支镜组(χ^(2)=6.30,P<0.05)。结论 相对于纤支镜定位,可视化超声用于老年喉罩全麻手术能减少对呼吸和咽部的刺激,提升喉罩正常通气率,降低并发症发生率。Objective To compare the normal ventilation rate and complications of laryngeal mask surgery in elderly patients using visualization ultrasound and fiberoptic bronchoscopy positioning technology.Methods Totally 92 elderly patients who underwent laryngeal mask surgery at Yongkang Orthopedic Hospital were selected and divided into two groups based on different positioning methods:ultrasound group(n=46)and fiberoptic bronchoscopy group(n=46).The ultrasound group used visual ultrasound positioning,while the fiberoptic bronchoscopy group used fiberoptic bronchoscopy positioning.The ventilation status,mean arterial pressure(MAP),heart rate(HR) levels,serum immunoglobulin M(IgM),immunoglobulin A(IgA),immunoglobulin G(IgG)levels,and incidence of complications between two groups were compared.Results The placement time and adjusted normal ventilation time of the ultrasound group were lower than those of the bronchoscope group(t=5.63,6.20,P<0.05).At T_2,T_3,T_4,T_5,and T_6,the MAP and HR levels in the ultrasound group were lower than those in the bronchoscopy group(t=7.82,9.36,5.22,6.20,8.46,8.64,6.32,8.10,7.69,8.63,P<0.05).On the first day after surgery,the levels of serum IgM,IgA,and IgG in the ultrasound group were higher than those in the bronchoscopy group(t=12.84,5.80,4.19,P<0.05).The incidence of complications in the ultrasound group was lower than that in the bronchoscopy group(χ^(2)=6.30,P<0.05).Conclusion Compared to fiberoptic bronchoscopy,visual ultrasound used in elderly laryngeal mask surgery under general anesthesia can reduce irritation to the respiratory and pharyngeal areas,improve normal ventilation rate of the laryngeal mask,and reduce the incidence of complications.

关 键 词：可视化超声 纤支镜 喉罩全麻 通气率 

分 类 号：R47[医药卫生—护理学]