两种选择喉罩型号的方法对术后咽喉部并发症的影响

1.Department of Anesthesiology,the Second Affiliated Hospital of Dalian Medical University,Dalian 116027,China; 2.Dalian Medical University,Dalian 116044,China

关键词:  喉罩  型号  标准体重  并发症

Key words:  laryngeal mask airway  size  standard body weight  complication

摘要:

目的　观察两种选择喉罩型号的方法在使用中的效果，比较术后咽喉部并发症。方法　择期全麻患者40例，随机分为A、B两组，每组20例，A组按照实际体重选择喉罩；B组计算患者的标准体重，再根据体重选择喉罩。患者入室，常规行全麻诱导，插入选定型号的喉罩。行喉罩的通气和对位检查，各项检查完成并达到满意后固定，行机械通气。术中持续泵入丙泊酚，瑞芬太尼，间隔给予顺苯磺阿曲库铵。手术结束患者清醒后，拔除喉罩，观察并记录喉罩上是否带有血丝。术后对患者进行随访，观察患者咽喉部并发症的发生情况。结果　A组的喉罩密封压（21.00±2.08）cmH2O要低于B组（24.00±2.83）cmH2O，B组的插入时间（15.05±2.56）s短于A组（16.95±3.20）s、咽喉部黏膜损伤发生率最低（5%）、组术后咽痛发生率最低（15%）。结论　两种方法均可达到选择喉罩完成通气的目标，但按照标准体重计算，对咽喉部黏膜的损伤更小，咽喉部并发症更少。

Abstract:

Objective 〖WTBZ〗To observe the effect of two methods of LMA model in use, comparing the throat surgery complications.〖WTHZ〗Methods 〖WTBZ〗The 40 patients undergoing general anesthesia are randomly divided into A, B two groups.Each group is 20 cases.Group A is selected according to the actual weight of the LMA; The patients of Group B are calculated with standard weight, selecting the laryngeal mask based on body weight.In the operation room,the patients are induced routinly of general anesthesia, inserted the selected model LMA. Laryngeal mask ventilation and parity, the inspection is completed and satisfactory after fixation, mechanical ventilation.Intraoperative continuous infusion of propofol and remifentanil, the interval to give cis-benzene sulfonamide atracurium.After surgery, the patients awake, removing of laryngeal mask.The laryngeal cast is observed and recorded with bloodshot . After surgery, patients are observed the incidence of throat complications.〖WTHZ〗Results〖WTBZ〗 In Group A, the seal pressure of laryngeal mask (21.00±2.08)cmH2O is lower than Group B (24.00±2.83)cmH2O.The insertion time of Group B(15.05±2.56)seconds is shorter than Group A (16.95±3.20)seconds. throat Department of the lowest incidence of mucosal injury (5%), the lowest incidence of postoperative sore throat (15%).〖WTHZ〗Conclusion 〖WTBZ〗Both methods achieve to complete selection laryngeal mask ventilation goal, but in accordance with the standard weight calculation, the throat mucosa damage is smaller, fewer throat complications.