SLIPA喉罩与双管喉罩在甲状腺手术中应用效果比较.docVIP

SLIPA喉罩与双管喉罩在甲状腺手术中应用效果比较 　　[摘要] 目的 观察SLIPA、双管喉罩（PLMA)在甲状腺手术中的麻醉通气效果，探讨两者的安全性和有效性。方法 甲状腺手术患者90例，随机分为SLIPA组、PLMA组和气管导管组，每组30例。记录三组患者插喉罩（管）成功行机械通气即刻（T1）、肩垫高头后仰位后即刻（T2）、手术开始（T3）、术毕1 min（T4）的SpO2、气道峰压和呼末二氧化碳分压（PETCO2）、喉罩气道密封压。结果 SLIPA组气道密封压在T2、T3时间点较T1时间点有变化，差异有统计学意义。PLMA组气道密封压（P密封压）在T2、T3时间点较T1时间点有变化，差异无统计学意义。 结论 在甲状腺手术期间，SLIPA、PLMA可以实现有效通气，但SLIPA应密切监测通气指标。 　　[关键词] 喉罩；甲状腺手术；气道密封压 　　[中图分类号] R614[文献标识码] B[文章编号] 1673-9701（2014）16-0079-03 　　 　　Application effect of SLIPA LMA and PLMA on the thyroid surgery 　　LI Hongbao1 HE Jianguo2 　　1.Department of Anesthesiology, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315000, China; 2.Department of Anesthesiology, Ningbo First Hospital, Ningbo 315010, China 　　[Abstract] Objective To study the anesthetic and ventilation results of SLIPA LMA and PLMA in the thyroid surgery so as to explore their secuirty and effective degrees. Methods A total of 90 patients undergoing thyroid surgery were randomly divided into three groups: the SLIPA group, the PLMA group and the tracheal intubation group, with 30 cases in each group. The SpO2, Ppeak, PETCO2 and seal pressure of LMA at the mechanical ventilation time after the successful connection of LMA (tracheal intubation)(T1), the time when the shoulder was padded and the head fell backwards (T2), the time for surgery (T3), and 1 min after the surgery (T4) in the patients of these three groups were recorded. Results The airway seal pressure of SLIPA group varied at T2 and T3 compared with T1, and the difference was of statistical significant. The airway seal pressure of PLMA group(P seal pressure) changed at T2 and T3 compared with T1, and the difference was of no statistical significance. Conclusion During the thyroid surgery both SLIPA and PLMA could achieve effective ventilation, but the the ventilation index of SLIPA should be monitored closely. 　　[Key words] LMA; Thyroid surgery; Airway seal pressure随着麻醉技术的发展，特别是喉罩的发展，喉罩有不用喉镜暴露声门、不刺激气管、患者心血管反应轻、耐受性好等优点，越