插管型喉罩在无痛支气管镜检查中应用.doc

插管型喉罩在无痛支气管镜检查中应用【摘要】 目的 观察插管型喉罩在无痛支气管镜检查中的应用效果。方法 将老年纤支镜检患者40例随机均分两组，A组为插管型喉罩组21例，B组为静脉全麻组19例。观察指标：BP、HR、SpO?2、麻醉效果评级、镜检医师满意度、两组患者术中不良反应及麻醉再接受度。结果 插管型喉罩组患者SpO?2、麻醉效果评级、镜检医师满意度均好于静脉全麻组。结论 插管型喉罩在老年纤支镜检中麻醉及通气效果满意，麻醉安全性高。? 【关键词】 插管型喉罩； 无痛支气管镜?? Application of improved laryngeal mask in painless fiberoptic bronchoscopy QIAN Jiang, REN Jun, WANG Ying-jun, et al. The Hospital of Xinjiangshengchanjianshebingtuan, Xinjiang 830002, China? 【Abstract】 Objective To observe the clinical effect of improved laryngeal mask in painless fiberoptic bronchoscopy.Methods Forty patients undergoing fibemptic bronchoscopy, were randomly divided into controlled improved laryngeal mask group(Group A,n=21) and vein general anesthesia group(Group B, n=19).The patients in Group B maintained spontaneous respiration.The blood pressure(BP),heart rate(HR),and pulse oxygen saturation(SpO?2) were evaluated during endoscope inspection.The operating condition and operating time of the two groups were recorded,and side-effects during the inspection were also observed.Results The SpO?2 of the patients in Group A remained at a higher level. The operating condition in Group A was significantly superior to the Group B(P＜0.05), and the operating time in Group A was significantly shorter than that in Group B(P＜0.05).Less irritating cough, breathlessness,laryngospasm,and body movement happened in Group A than those in Group B(P＜0.05).Conclusion Improved laryngeal mask is a safe and effective alternative to painless fiberoptic bronchoscopy.? 【Key words】 Laryngeal mask; Painless fiberoptic bronchoscopy? doi:10.3969/j.issn.1674-4985.2012.03.005 ?? 目前，无痛纤维支气管镜（FB）检查主要的麻醉方法是静脉全身麻醉，采用的静脉麻醉药主要以异丙酚合并芬太尼或瑞芬太尼为主，这种组合起效快，诱导迅速，镇静镇痛充分，维持平稳，苏醒快。但这种组合存在致命的缺点――呼吸抑制。为解决无痛纤维支气管镜检查中的因呼吸抑制所致的低氧血症，本研究将插管型喉罩+三通接头（有双腔管接头配装），侧通气管接麻醉机行控制或辅助通气，有效解决呼吸抑制问题，现将其麻醉及通气效果报告如下。? 1 资料与方法? 1.1 一般资料 本组40例患者，其中男30例，女10例，年龄60～80岁，体重指数＜29 kg/m?2，ASA分级Ⅰ～Ⅲ级。随机均分两组，A组为插管型喉罩组，B组为静脉全麻组。麻醉及术者人员相对固定。各组患者的一般资料如年龄、性别、体重、ASA分级、手术时间差