侧卧位置入双管喉罩在吻合器痔上粘膜环切术中的应用(1)
摘 要：目的 观察侧卧体位置入双管美迪斯喉罩维持在PPH术中的应用效果。方法 选择2016年11月～2017年10月行PPH术的60例患者，按照数字表法随机分成两组，每组30例。观察组患者侧卧体位置入喉罩，对照组患者平卧体位置入喉罩。记录两组患者置入喉罩时通气情况、操作简易性、操作引起的并发症及手术时间，手术准备时间。结果 两组喉罩通气情况对比，无统计学差异(P>0.05)；L组和S组操作同样简单有效；手术准备时间S组( 9.63±1.31)min，高于L组( 6.13±1.12)min，差异有统计学意义(P<0.05)；拔除喉罩后罩体背部染血S组多于L组，差异有统计学意义(P<0.05)；两组术后咽痛对比，差异无统计学意义(P>0.05)。结论 侧卧体位置入喉罩安全简便，气道密封效果好，不良反应少，用于PPH术患者的全麻气道管理安全可靠，提高了手术床的利用率，值得临床推广。
关键词：吻合器痔上粘膜环切术(PPH)；喉罩；侧卧位
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.032
, http://www.100md.com
文章编号：1006-1959(2018)09-0109-03
Abstract：Objective To observe the effect of lateral decubitus position in the operation of double tube and laryngeal mask airway in PPH.Methods 60 patients undergoing PPH from November 2016 to October 2017 were randomly divided into two groups with 30 cases in each group.The patients in the observation group were placed in the laryngeal mask at the lateral body position，and the patients in the control group were placed in the laryngeal mask in the supine body position.The ventilation，operation simplicity， complications，operation time and preparation time were recorded during laryngeal mask placement in the two groups.Results There was no significant difference in laryngeal mask ventilation between the two groups(P>0.05).The operation of group L and group S was as simple and effective as group S(9.63+1.31)min，higher than that of group L(6.13+1.12)min，and the difference was statistically significant (P<0.05)；After removing larynx mask，group S was more than group L，the difference was statistically significant(P<0.05)，there was no significant difference in postoperative sore throat between the two groups(P>0.05).Conclusion The position of the lateral body position into the laryngeal mask is safe and simple，the airway sealing effect is good，and the adverse reaction is few.It is safe and reliable for the airway management of the general anesthesia for the patients with PPH.It improves the utilization rate of the operating bed and is worthy of clinical popularization.
, 百拇医药
Key words：Stapler hemorrhoidectomy (PPH)；Laryngeal mask airway；Lateral decubitus position
吻合器痔上粘膜環切术(procedure for prolapse and hemorrhoids，PPH)作为一种治疗脱垂痔的新方法，术后疼痛轻，住院时间短，很快恢复正常工作和生活，深受患者接受[1]。PPH均采用左侧卧位，体位较舒适，同时可以保护患者隐私，尤其是女性患者。PPH时间较短，根据患者和术者的治疗需求采取快速安全的气道管理方式有助于缩短麻醉时间，提高手术床利用率。PPH术绝大多数在平卧位置入喉罩后再摆侧卧位，摆好体位后再行喉罩置入鲜有报道，本研究目的旨在观察侧卧位置入双管喉罩(GLMA)在PPH术中应用的安全性及有效性，为临床提供参考，现分析如下。
1资料与方法
1.1一般资料 选择北京市普仁医院2016年11月～2017年10月择期行手术时间<1 h 的PPH术患者60例，本次研究经过医院伦理委员会批准。纳入标准：①ASAⅠ～Ⅱ级；②术前检查未发现心肺等疾病；③口咽部解剖结构未见异常；④无颈部活动受限、饱胃以及胃食管反流病史。排除标准：①咽部手术史；②咽喉疼痛患者。将患者按数字表法随机分为侧卧位置入喉罩(L组)，平卧位置入喉罩(S组)，每组30例。L组男性17例，女性13例，年龄26～58 岁，平均年龄(45.36±7.27)岁，BMI平均值(22.34 ±2.77)kg/m2。S组男性16例，女性14例，年龄26～57 岁，平均年龄(46.12 ±6.65)岁，BMI平均值(21.68±2.79)kg/m2。两组患者性别比、年龄、BMI 等一般资料对比，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(苏汉银 刘红梅 柯丹)
关键词：吻合器痔上粘膜环切术(PPH)；喉罩；侧卧位
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.032
, http://www.100md.com
文章编号：1006-1959(2018)09-0109-03
Abstract：Objective To observe the effect of lateral decubitus position in the operation of double tube and laryngeal mask airway in PPH.Methods 60 patients undergoing PPH from November 2016 to October 2017 were randomly divided into two groups with 30 cases in each group.The patients in the observation group were placed in the laryngeal mask at the lateral body position，and the patients in the control group were placed in the laryngeal mask in the supine body position.The ventilation，operation simplicity， complications，operation time and preparation time were recorded during laryngeal mask placement in the two groups.Results There was no significant difference in laryngeal mask ventilation between the two groups(P>0.05).The operation of group L and group S was as simple and effective as group S(9.63+1.31)min，higher than that of group L(6.13+1.12)min，and the difference was statistically significant (P<0.05)；After removing larynx mask，group S was more than group L，the difference was statistically significant(P<0.05)，there was no significant difference in postoperative sore throat between the two groups(P>0.05).Conclusion The position of the lateral body position into the laryngeal mask is safe and simple，the airway sealing effect is good，and the adverse reaction is few.It is safe and reliable for the airway management of the general anesthesia for the patients with PPH.It improves the utilization rate of the operating bed and is worthy of clinical popularization.
, 百拇医药
Key words：Stapler hemorrhoidectomy (PPH)；Laryngeal mask airway；Lateral decubitus position
吻合器痔上粘膜環切术(procedure for prolapse and hemorrhoids，PPH)作为一种治疗脱垂痔的新方法，术后疼痛轻，住院时间短，很快恢复正常工作和生活，深受患者接受[1]。PPH均采用左侧卧位，体位较舒适，同时可以保护患者隐私，尤其是女性患者。PPH时间较短，根据患者和术者的治疗需求采取快速安全的气道管理方式有助于缩短麻醉时间，提高手术床利用率。PPH术绝大多数在平卧位置入喉罩后再摆侧卧位，摆好体位后再行喉罩置入鲜有报道，本研究目的旨在观察侧卧位置入双管喉罩(GLMA)在PPH术中应用的安全性及有效性，为临床提供参考，现分析如下。
1资料与方法
1.1一般资料 选择北京市普仁医院2016年11月～2017年10月择期行手术时间<1 h 的PPH术患者60例，本次研究经过医院伦理委员会批准。纳入标准：①ASAⅠ～Ⅱ级；②术前检查未发现心肺等疾病；③口咽部解剖结构未见异常；④无颈部活动受限、饱胃以及胃食管反流病史。排除标准：①咽部手术史；②咽喉疼痛患者。将患者按数字表法随机分为侧卧位置入喉罩(L组)，平卧位置入喉罩(S组)，每组30例。L组男性17例，女性13例，年龄26～58 岁，平均年龄(45.36±7.27)岁，BMI平均值(22.34 ±2.77)kg/m2。S组男性16例，女性14例，年龄26～57 岁，平均年龄(46.12 ±6.65)岁，BMI平均值(21.68±2.79)kg/m2。两组患者性别比、年龄、BMI 等一般资料对比，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(苏汉银 刘红梅 柯丹)