摘要
目的通过比较两组病人分别置入喉罩和气管内插管的成功率和血流动力学变化,凸显食管引流型喉罩(PLMA)在颈椎骨折手术麻醉中的优越性。方法将60例ASA Ⅰ～Ⅲ级颈椎骨折需行手术治疗的病人随机分为两组:食管引流型喉罩组(A组)和盲插气管插管组(B组)。分别按常规麻醉诱导后置入气管导管或食管引流型喉罩(下统称麻醉构件)。记录两组患者诱导前、诱导后、置构件后1 min、3 min、拔出构件前及后5 min的SBP、DBP和HR值,还有置入构件所需的时间、成功率及并发症等。结果成功置入构件后1 min和3 min的BP及拔出构件前后的BP、HR组间比较差异均有统计学意义(P<0.05),B组高于A组;而插置构件所用的时间和低氧血症、呛咳、支气管痉挛及出血血肿等麻醉并发症B组亦明显高于A组。结论麻醉采用PLMA是一种操作简单快捷、安全舒适、术后呼吸道并发症少的呼吸支持方法,对颈椎骨折等插管困难病人尤其适用。
Objective To highlight the advantages of proseal laryngeal mask airway （PLMA） in the anesthesia for cervical spine fracture surgery by comparing the success rates and hemodynamic changes between groups of patients inserted with laryngeal mask and endotraeheal intubation respectively. Methods Sixty ASA status I-Ⅲ patients with cervical spine fracture requiring surgery were randomly divided into two groups： PLMA group （Group A） and blind endotraeheal intubation group （Group B）. After regular anesthesia induction, tracheal catheter and PLMA （hereinafter collectively called anesthesia components） were placed respectively. SBP, DBP and HR value before and after induction, at 1 min and 3 min after placing components, 5 rain before and after removing components were recorded as well as the time required for placing the components, success rates and complications. Results There were significant differences in BP at 1 min and 3 min after successfully placing the components, and in BP and HR before and after removing the components for between groups （P 〈 0. 05 ） ; The values of Group B were higher than those of Group A; as for the time required for placing the components and anesthesia complications such as hypox- emia, irritating cough, bronehospasm, hemorrhage and hematoma, Group B was also significantly higher than Group A. Conclusion Adopting proseal laryngeal mask airway （PLMA） in anesthesia were a breath supporting method with easy operation, safety and rapidness, few postoperative respiratory complications, which is especially applicable for patients who are difficult for intubation because of cervical spine fracture etc.
出处
《中国临床新医学》
2011年第7期629-632,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
食管引流型喉罩
颈椎骨折
麻醉
Proseal laryngeal mask airway
Cervical spine fracture
Anesthesia
