摘要
目的探讨可视可塑型喉镜定位喉罩置入法在全身麻醉气管插管中的应用效果。方法抽取2015年8月至2017年3月郑州市第二人民医院收治的行全身麻醉气管插管患者120例作为研究对象,按随机信封法分为A、B、C三组,每组40例。三组患者均使用可气管插管的第四代喉罩,其中A组患者给予可视可塑型喉镜辅助,B组患者给予纤维支气管镜辅助,C组患者给予盲探置入法。比较三组患者插管到位率、气道压力情况和并发症情况,并评估围术期不同时间点血流动力学和应激反应水平。结果A组患者一次性喉罩置入到位率高于B、C组(P<0.05);A组患者喉罩置入理想位置时气道峰压(PIP)<20 cmH_(2)O(1 cmH2O=0.098 kPa)例数多于B、C组(P<0.05);A组患者在插罩即刻(T2)、拔罩即刻(T4)时刻血压(收缩压、舒张压)低于B、C组(P<0.05),其余时间三组比较差异未见统计学意义,三组各时间点心率(HR)比较差异未见统计学意义(P>0.05);A组患者拔罩前(T3)、T4时刻皮质醇(Cor)水平低于B、C组(P<0.05),其余各时间点三组比较差异未见统计学意义(P>0.05);A组患者并发症发生率低于B、C组(P<0.05)。结论可视可塑型喉镜定位喉罩置入法应用于全身麻醉气管插管患者,可提高插入喉罩位置准确率,减轻应激反应,在一定程度上改善血流动力学,减少相关并发症。
Objective To study the application effect of laryngeal mask airway insertion positioned by laryngoscope assisted visual soft lens in tracheal intubation of general anesthesia.Methods A total of 120 patients who underwent surgery and required general anesthesia tracheal intubation in Zhengzhou Second People’s Hospital from August 2015 to March 2017 were selected as the research subjects.They were divided into group A,group B and group C by random envelope method,with 40 cases in each group.All the three groups of patients used a fourth-generation laryngeal hood that could be tubed,patients in group A were given visual plastic laryngoscope,patients in group B were given fiberoptic bronchoscope,and patients in group C were given blind probe placement.The successful intubation rates,airway pressure and complications in the three groups were compared.Hemodynamics and stress response levels at different time points during the perioperative period were evaluated.Results The success rate of one-time insertion in group A was significantly higher than that in groups B and group C(P<0.05).Patients with peak inspimtory pressure(PIP)<20 cmH_(2)O(1 cmH2O=0.098 kPa)in group A when the laryngeal mask airway was placed in the ideal position were significantly more than those in group B and group C(P<0.05).Blood pressure(systolic and diastolic blood pressure)of group A was significantly lower than that of group B and group C at immediate insertion(T2),immediate removal(T4),P<0.05,but there were no significant differences among the three groups at other time points.There was no significant difference in heart rate(HR)among the three groups at each time point(P>0.05);cortisol(Cor)levels in group A were significantly lower than those in group B and group C at before hood removal(T3)and T4(P<0.05),but there were no significant differences among the three groups at other time points(P>0.05).The incidences of complications in group A were significantly lower than those in group B and group C(P<0.05).Conclusions The application of laryngeal mask airway insertion positioned by laryngoscope assisted visual soft lens in tracheal intubation of general anesthesia can improve the accuracy of laryngeal mask airway insertion,alleviate stress response,improve hemodynamics to a certain extent,and reduce related complications.
作者
张国生
牛金玉
王开伟
孙世龙
沙青锋
王晶涛
Zhang Guosheng;Niu Jinyu;Wang Kaiwei;Sun Shilong;Sha Qingfeng;Wang Jingtao(Department of Anesthesiology,Zhengzhou Second People’s Hospital,Zhengzhou 450000,China;Department of Anesthesiology,Henan Provincial People’s Hospital,Zhengzhou 450000,China)
出处
《中国实用医刊》
2021年第4期8-12,共5页
Chinese Journal of Practical Medicine
基金
河南省医学科技攻关计划项目(201504056)。
关键词
喉镜
可视软镜
喉罩置入
全身麻醉
气管插管
Laryngoscope
Visual lens
Laryngeal mask airway insertion
General anesthesia
Endotracheal intubation
