摘要
目的通过自制简易套囊压力计测定不同套囊充气容积下4号驼人喉罩的套囊压力和相对应的气道密闭压，并观察其对患者术后咽部并发症的影响。方法选择择期行泌尿外科腔内、乳腺包块切除手术，体重50—70kg的患者80例。所有患者在全麻诱导后，插入4号驼人喉罩，采用静吸复合全麻，并随机分为2组（每组40例）。常规组（C组）：喉罩套囊充气量30ml；低充气量组（L组）：套囊充气量15ml。分别采用自制套囊压力计和换能器测定术中套囊压力，评估相对应的气道密闭压和拔除喉罩即刻及拔除后2、24、48h患者咽部并发症的发生情况。结果自制套囊压力计与换能器测定喉罩套囊压力值一致。15ml充气量比30rnl充气量产生的套囊压力明显降低（P〈0．01），而2组气道密闭压的差异无统计学意义（P〉0．05）。L组、c组患者喉罩拔除即刻咽部不适发生率分别为82．5％、87．5％，差异无统计学意义；而L组在喉罩拔除后2、24、48h咽部疼痛的发生率比C组明显降低（P〈0．05）。结论自制套囊压力计能准确监测喉罩套囊压力，4号驼人喉罩15rnl充气量可产生满意的气道密闭压，降低术后咽部并发症发生率。
Objective To measure the intracuff pressure under size 4 laryngeal mask airway （LMA） and the corresponding airway pressure by a self - made intracuff manometer and observe the incidence of postoperative pharyngeal com- plication. Methods Eighty ASA Ⅰ - Ⅱ patients weighting 50 - 70 kg were included into the current study who underwent mammary mass resection or urologic endosocopic surgery from January 2013 to January 2014 in our hospital. After general anesthesia, all patients were inserted with size 4 LMA and received combined intravenous - inhalation anesthesia. Then the patients were randomly divided to two groups （40 in each group）. The routine care group （ group C） ： the recommended maximal cuff volume was 30 ml for size 4 LMA. The low cuff volume group （ Group L） ： half of the recommended maximal cuff volume, i.e. 15 ml of air was inflated. The intracuff pressure was measured by two different methods simultaneously （ a self - made manometer with metal bourdon gauge v.s. a press transducer connected to Philips monitor）. The airway pressures were measured by auscultation at neck with a stethoscope. The incidence of pharyngeal complication 0, 2, 24 and 48 hours after the removal of LMA was recorded. Results The intracuff pressure measured by the self - made manometer was consistent with that recorded by the press transducer. The intracuff pressure when 15 ml of air was inflated was remarkably lower than that after inflation of 30 ml air （ P 〈 0.01 ）. However, no statistical difference was found as to airway pressure between both groups （P 〉 0.05 ）. The uncomfortable rates of both groups were 82.5% and 87.5% when LMA was removed, without any statistical difference. Compared with group C, patients in group L presented striking less incidence of sore throat 2, 24 and 48 hours after the removal of LMA （P 〈 0.05）. Conclusion Self - made manometers can measure LMA intracuff pressure currently. Size 4 Torten classic LMA can be adopted which inflates 15 ml of air to result
出处
《徐州医学院学报》
CAS
2014年第11期742-746,共5页
Acta Academiae Medicinae Xuzhou
基金
江苏省自然科学基金面上项目（BK2012532）
南京市卫生局青年卫生人才项目第二层次.
关键词
喉罩
囊内压
术后咽部并发症
laryngeal mask airway
intracuff pressure
postoperative pharyngeal complication
