婴儿眼科手术中的应用喉罩通气的特点  

Laryngeal mask airway ventilation in infant ophthalmic surgery

作　　者：王咏怡 张睿 陈倩茹[1] WANG Yong-yi;ZHANG Rui;CHEN Qian-ru(Department of Anesthesia,State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology Visual Science,Guangdong Provincial Clinical Research Center for Ocular Diseases,Guangzhou 510060,Guangdong,China)

机构地区：[1]中山大学中山眼科中心麻醉科、眼病防治全国重点实验室、广东省眼科视觉科学重点实验室、广东省眼部疾病临床医学研究中心,广东广州510060

出　　处：《广东医学》2025年第3期471-475,共5页Guangdong Medical Journal

基　　金：广东省自然科学基金研究项目(2021A1515010553)。

摘　　要：目的分析喉罩通气应用于婴儿眼科全麻手术中的特点。方法选取2022年1月到2023年12月间在中山大学中山眼科中心接受喉罩通气下全麻眼科手术0~1周岁内婴儿的病例资料,分析患儿术前情况(性别、年龄、身高、体重、ASA分级)、全麻药物(是否使用肌松药物)、术中生命体征(心率变化与呼吸参数)、手术时长及术后在麻醉监护室的情况(复苏时间、呼吸道不良事件)。结果共474例全麻下眼科手术的婴儿纳入本研究,其中15例(3.1%)患儿在全麻诱导期间,喉罩置入失败改行气管插管,喉罩的置入成功率96.8%,且肌松药物的使用不影响喉罩的置入成功率。所有患儿均顺利完成手术,在手术期间均未出现喉罩移位或气管内导管脱出现象。与喉罩失败组比较,喉罩组患儿苏醒期低氧血症的发生率明显降低(P<0.001)。结论喉罩通气能有效满足婴儿眼科手术全麻的需要,降低苏醒期低氧血症的发生。Objective To analyze the characteristics of laryngeal mask airway(LMA)ventilation in infants undergoing ophthalmic surgery under general anesthesia.Methods Data from infants aged 0-1 years who underwent general anesthesia with LMA ventilation for ophthalmic surgery at our hospital between January 2022 and December 2023 were collected.Preoperative conditions(gender,age,height,weight,ASA classification),anesthetic drugs(including muscle relaxants),intraoperative vital signs(heart rate and respiratory parameters),surgery duration,and postoperative conditions in the anesthesia recovery room(recovery time,airway adverse events)were analyzed.Results A total of 474 infant ophthalmic surgeries under general anesthesia were included.Among these,LMA insertion failed in 15 cases(3.1%)during induction and was switched to endotracheal intubation,resulting in an LMA insertion success rate of 96.8%.The use of muscle relaxants did not affect the success rate of LMA insertion.All surgeries were completed successfully without LMA displacement or endotracheal tube dislodgement during the procedures.Compared to the LMA failure group,the LMA group had a significantly lower incidence of hypoxemia during the recovery period(P<0.001).Conclusion LMA ventilation effectively meets the requirements for general anesthesia in infant ophthalmic surgery and reduces the incidence of hypoxemia during the recovery period.

关 键 词：喉罩 婴儿 眼科手术 安全性 

分 类 号：R726[医药卫生—儿科] R826.2*4[医药卫生—临床医学]