弹性探条引导放置双管喉罩的作用(1)
【摘要】 目的 本研究比较了双管喉罩(LMA-ProSealTM，PLMA)的三种插入方法:徒手置入法、工具置入法和弹性探条引导下置入法的成功率和并发症。方法 择期手术患者180例，ASAⅠ或Ⅱ级，随机分为3组，每组60例。Ⅰ组用徒手法，Ⅱ组用器械法，Ⅲ组用探条法。用纤维支气管镜观察PLMA的到位情况。记录拿起喉罩到插管成功到建立气道的时间以及插管次数。记录喉罩上有无染血。术后2 h随访，记录咽痛、发声、吞咽困难等并发症。结果 一次插管成功率分别为:徒手法85%，器械法88%，探条法100%。探条法的一次插管成功率较其他两组高(P<0.05)；3次插管成功率分别为徒手法95%，器械法97%，探条法100%；3次的总成功率3组之间差异无统计学意义(P>0.05)；总的插管时间探条法的时间较短(P<0.05)；3组的染血率和咽痛率无显著性差异。结论 使用喉镜在弹性探条引导下置入双管喉罩(LMA-ProSealTM)的方法比徒手法和器械法更加可靠快捷。【关键词】喉罩；双管喉罩；弹性探条
【Abstract】 Objective To compare three techniques for insertion of the ProSealTM laryngeal mask airway.Methods 180 patients,ASAⅠor Ⅱ,for selective surgery were randomized into three groups.There were 60 patients in each group.Patients in groupⅠwere digital technique,those in groupⅡusing introducer tool technique,those in group Ⅲ using gum elastic bougie-guided technique.The position of PLMA was examined by fiberoptic bronchoscopy.Anesthesia was induced,size 5 were used in male while size 4 were used in female patients.Insertion time and success attempts were recorded.Blood staining on LMA and sore throat,dysphagia,dysphonia 2 hours after surgery were recorded.Results Success ratio at the first attempt were digital,85%,IT 88%,GEB 100%.GEB guided technique success was more frequently than the other two groups; success after three attempts was similar:digital,95%,IT 97%,GEB 100%.There was no significant difference among general success after three attempts(P>0.05).GEB guided technique showed less effective airway time.There was no difference for blood staining and sore throat among three groups(P>0.05).Conclusion GEB guided technique is more reliable. ......
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