摘要
目的观察魏氏鼻咽通气道声门上喷射通气在肥胖患者宫腔镜手术中的临床效果。方法择期全身麻醉下行宫腔镜手术的肥胖患者80例随机分为两组,每组40例。W组置入魏氏鼻咽通气道,行喷射通气;L组插入LMA喉罩,行间歇正压通气。记录麻醉诱导前(T0)、置入鼻咽通气道或喉罩时(T1)、术毕拔出鼻咽通气道或喉罩时(T2)的HR、MAP和SpO_(2)。比较两组建立气道所需时间、术中SpO_(2)<95%和需要气管插管的发生率。观察不良反应发生情况。结果两组T0、T1和T2时的HR、MAP和SpO_(2)均无统计学差异(P>0.05)。与L组比较,W组建立气道所需时间较短[(14.5±3.3) s vs.(30.3±5.2) s](P<0.05),SpO_(2)<95%(2.5%vs.27.5%)和需要气管插管(2.5%vs.22.5%)的发生率较低(P<0.05)。两组术后烦躁、声嘶和鼻咽部不适等的发生率相仿(P>0.05),W组患者胃胀气的发生率低于L组(P<0.05)。结论魏氏鼻咽通气道声门上喷射通气可安全地用于肥胖患者宫腔镜手术中,操作简单,不良反应少。
Objective To observe the clinical efficacy of supraglottic ventilation with Wei nasal jet in the obese patients undergoing hysteroscopic surgery.Methods Eighty obese patients undergoing hysteroscopic surgery under general anesthesia were randomly divided into two groups with 40 cases each.Group A was ventilated with supraglottic Wei nasal jet and group L was ventilated with intermittent positive pressure ventilation via laryngeal mask airway.The HR,MAP and SpO_(2) were recorded at the time points of before anesthesia induction(T0),during inserting Wei nasal jet or laryngeal mask(T1)and removing Wei nasal jet or laryngeal mask after operation(T2).The time for airway establishment and the percentages of the patients with SpO_(2)<95%and requiring endotracheal intubation were compared between the two groups.The adverse responses were observed as well.Results There were no significant differences in HR,MAP and SpO_(2) at T0,T1 and T2 between the two groups(P>0.05).The time for airway establishment in group W was significantly less than that in group L[(14.5±3.3)seconds vs.(30.3±5.2)seconds](P<0.05).The percentages of the patients with SpO_(2)<95%(2.5%vs.27.5%)and requiring endotracheal intubation(2.5%vs.22.5%)were lower in group W than those in group L(P<0.05).The incidence rates of postoperative restlessness,hoarseness and nasopharyngeal discomfort of two groups were similar(P>0.05).But the incidence of postoperative flatulence in group W was lower than that in group L(P<0.05).Conclusion Supraglottic ventilation with Wei nasal jet can be safely used in the obese patients undergoing hysteroscopic surgery with simple operation and less adverse response.
作者
吴丽芳
WU Lifang(Department of Anesthsiology,Deqing Hospital of Chinese Medicine,Deqing 313200,CHINA)
出处
《江苏医药》
CAS
2021年第6期623-626,共4页
Jiangsu Medical Journal
