摘要
目的评价全身麻醉下三通喉罩(TLMA)通气在老年人纤维支气管镜肺活检的应用价值。方法实施纤维支气管镜肺活检的老年患者15例,年龄66～89岁,在快速诱导全身麻醉下实施TLMA插入。插入成功后,TLMA的标准端口连接麻醉机进行机械通气,从TLMA另一带有密封胶帽端口置入纤维支气管镜,经声门进入气管、支气管,实施肺活检术。记录麻醉前5min时(T0)、插入喉罩后即刻(T1)、通气1min时(T2)、通气5min时(T3)、通气10min时(T4)、手术结束时(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏氧饱和度(SpO2);记录患者通气T1、T2、T3、T4、T5、的潮气量(VT),气道峰压(Ppeak)及呼气末二氧化碳分压(PETCO2);测定T0、T3、T4、T5时间点的血气分析。结果全部15例手术顺利完成,血压平稳;术中VT、Ppeak、PETCO2和SpO2波动于正常范围;术后恢复良好,无明显并发症。结论TLMA用于老年人支气管镜肺活检安全可靠、效果满意、并发症少,具有临床应用价值。
[ Objection ] To evaluate the application value of three-way laryngeal mask airway （TLMA） ventilation under general anesthesia to transbronchial lung biopsy （TBLB） in elders. [Methods] Fifteen patients aged from 66 to 89 yeas were admitted for tracheal intubation with TLMA under general anesthesia for transbronchial lung biopsy. SBP, DBP, HR, and SpO2 were measured 5 min before the surgery （To）, immediately after inserting TLMA （T1）, 1 min after ventilation （T2）, 5 min after ventilation （T3）, 10 min after ventilation （T4）, at the end of the operation （T5）. Peak inspiratory airway pressure （Ppeak）, tidal volume （VT） and expiratory CO2 pressure （PETCO2） were recorded at T1, T2, T3, T4 and T5. Blood specimens were taken at T1, T2, T3, T4 and T5 for blood gas analysis. Effect of anesthesia and operation were recorded. [Results] All the operations were successful, satisfactory effects were observed in the 15 cases under study, no side effect and complications were observed in any cases. [ Conclusion ] TLMA for transbmnchial lung biopsy is a simple and safe method. Adopting TLMA under general anesthesia to transbronchial lung biopsy would control respiration according to the demand at any time. It may obtain the respiratory control power, guarantee good ventilation and oxygen supply, and considerably improve the safety of anesthesia.
出处
《中国内镜杂志》
CSCD
北大核心
2009年第9期909-911,共3页
China Journal of Endoscopy
关键词
全身麻醉
三通喉罩
老年
纤维支气管镜肺活检
general anesthesia
three-way laryngeal mask airway （TLMA）
elders
transbronchial lung biopsy （TBLB）
