摘要
目的通过比较3号和4号一次性引流型双管喉罩在患者体重50~70kg的妇科全麻手术中的应用情况,探讨适合于妇科全麻患者的喉罩大小选择标准。方法选取2023年5月至11月间在中国医科大学附属盛京医院接受全麻妇科手术的患者300例作为研究对象,体重50~70kg,按照随机数字表法分为A组(3号喉罩组)和B组(4号喉罩组),每组150例。比较两组患者喉罩的一次置管成功率、最终置管失败率、置管时间及置入喉罩后的纤支镜定位等级、气道压、平均动脉压、心率和术后咽部并发症(咽痛、声音嘶哑、发干、出血等)间的差异。结果两组患者的一次置管成功率、置管时间比较差异有统计学意义(均P<0.05),最终置管失败率、置管后的气道压、平均动脉压和心率比较差异无统计学意义(均P>0.05)。A组纤支镜定位1级的占比(14%,21/150)少于B组(26.67%,40/150),3级、4级的占比及平均等级高于B组,差异均有统计学意义(均P<0.05)。A组术后咽部总并发症少于B组,其中咽痛和出血情况比较差异有统计学意义(均P<0.05),发干、声音嘶哑和其他不适比较差异无统计学意义(均P>0.05)。结论在患者体重50~70kg的妇科全麻手术中选用3号喉罩较4号喉罩更容易置入,喉罩通气口和声门对位更好且术后咽部并发症更少,所以根据性别标准选择3号喉罩更适合。
Objective To compare the application differences of disposable drainage double tube laryngeal mask airway(LMA)in gynecological general anesthesia surgery with patients weighing 50-70 kg,and to explore the selection criteria for LMA size suitable for gynecological general anesthesia patients.Methods A total of 300 patients who underwent general anesthesia gynecological surgery at the Shengjing Hospital of China Medical University from May to November 2023 were selected as the study subjects,weighing 50-70 kg.They were randomly divided into group A(No.3 laryngeal mask group)and group B(No.4 laryngeal mask group)according to a random number table method,with 150 patients in each group.Comparisons were made between two groups of patients in terms of the success rate of one tube placement,final tube placement failure rate,tube placement time,fiberoptic bronchoscopy positioning level,airway pressure,mean arterial pressure,heart rate,and postoperative pharyngeal complications(sore throat,hoarseness,dryness,bleeding,etc.)after laryngeal mask insertion.Results There was a statistically significant difference in the success rate and catheterization time between the two groups of patients(all P<0.05),while there was no statistically significant difference in the final catheterization failure rate,post catheterization airway pressure,mean arterial pressure(MAP),and heart rate(all P>0.05).The proportion of grade 1 fiberoptic bronchoscopy localization in group A(14%,21/150)was lower than that in group B(26.67%,40/150),while the proportion and average grade of grade 3 and 4 were higher than those in group B,and the differences were statistically significant(all P<0.05).The total number of postoperative pharyngeal complications in group A was less than that in group B,with statistically significant differences in sore throat and bleeding(P<0.05),but no statistically significant differences in dry hair,hoarseness,and other discomforts(all P>0.05).Conclusions In gynecological general anesthesia surgery for patients weighing 50-70 kg,using a No.3 laryngeal mask is easier to insert than a No.4 laryngeal mask,with better alignment of the laryngeal mask airway and glottis,and fewer postoperative pharyngeal complications.Therefore,selecting a No.3 laryngeal mask based on gender criteria is more suitable.
作者
李正钢
薛玉红
Li Zhenggang;Xue Yuhong(Department of Anesthesiology,Shengjing Hospital of China Medical University,Shenyang 110000,China;Department of Nephrology,Shengjing Hospital of China Medical University,Shenyang 110000,China)
出处
《中国医师杂志》
CAS
2024年第7期1066-1070,共5页
Journal of Chinese Physician
关键词
喉面罩
麻醉
全身
妇科外科手术
Laryngeal masks
Anesthesia,general
Gynecologic surgical procedures
