摘要
目的评价食管引流型喉罩(PLMA)应用于强直性脊柱炎患者行全髋置换术维持有效通气的可行性。方法拟行全髋置换术(THR)的强直性脊柱炎(AS)患者33例,随机分为气管插管组(TI组,n=18)和PLMA组(n=15),其中插管及放置喉罩成功者记录围麻醉期不同时点PETCO2、SpO2、平均气道压(Pmean)、气道峰压(Ppeak)、平台压(Pplat)、MAP、HR、气道开放时间、成功率、两组拔管期及术后相关的并发症。插管及放置喉罩失败者行纤维支气管镜气管插管,并记录插管及喉罩放置成功率。结果两组各时点间Pmean、Ppeak、Pplat、PETCO2相比差异均无统计学意义。PLMA组气道建立成功率明显高于TI组,且所需时间明显缩短(P<0.05);在人工气道建立成功时、建立后10min、拔管(喉罩)前即刻、拔管(喉罩)后即刻PLMA组的MAP低于TI组,HR均慢于TI组(P<0.05),PLMA组拔管期的分泌物及呛咳较TI组明显减少(P<0.05)。结论PLMA适用于拟行平卧下全麻的强直性脊柱炎手术患者,优于气管插管。
Objective To evaluate the feasibility of proseal laryngeal mask （PLMA） in ankylosing spondylitis （AS） patients with restrictive ventilation dysfunction undergoing-total hip replacement（THR）. Methods Thirty-three ASA I or Ⅱ patients undergoing THR were randomly allocated to group PLMA or tracheal intubation（TI） group. The parameters of sucessful cases monhored during intubation included PET CO2, SpO2, mean airway pressure （Pmean）, peak airway pressure （Ppeak）,platform airway pressure （Pplat）, MAP, HR. The time of PLMA inserting and the success rate for airway establishment as well as postoperative complications were recorded. Results There were no significant differences in PETCO2 , SpO2 , Pmean, Ppeak, Pplat, MAP, HR between two groups at all time points. The success rate of airway establishment was higher and the time of PLMA inserting was shorter in group PI.MA than those in group TI （P〈O. 05）. Haernodynamics was more stable in group PLMA than that in group TI during intubation and extubation. The higher incidence of coughing and salivation occurred in group TI. Conclusion PLAM has superiority over TI for airway establishment under general anesthesia in AS patients with supine position.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第11期935-937,共3页
Journal of Clinical Anesthesiology
基金
福建省卫生厅面向农村和城市社区推广适应技术项目档案号2008KT09课题编号200804
关键词
食管引流型喉罩
气管插管
强占性脊柱炎
全髋置换术
Proseal laryngeal mask
Endotracheal intubation
Ankylosing spondy litis
Total hip replacement
