作　　者： (陈春梅）; (刘具会）; (邓晓明）; (田鸣）;

机构地区： 中国医学科学院北京协和医学院整形外科医院麻醉科,北京100144

出　　处： 《中国医刊》 2017年第9期68-71,共4页

摘　　要： 目的比较鸣人喉罩和Supreme喉罩用于全麻乳腺整形手术的气道管理效果。方法纳入择期在全麻下行乳腺整形手术的患者70例,随机均分为鸣人喉罩组(M组)和Supreme喉罩组(S组),每组35例。记录两组喉罩的首次置入成功率、置入时间、气道密封压、气道峰压并行纤维支气管镜检查分级,评估喉罩对位情况;记录患者拔除喉罩时间以及拔除喉罩后反流误吸、低氧血症和喉罩染血等的发生情况;并记录术后24小时内咽痛、声音嘶哑、吞咽困难及口腔黏膜损伤等并发症的发生情况。结果两组患者均顺利完成喉罩置入,其首次置入成功率、喉罩置入时间、气道峰压、拔除喉罩时间、拔除喉罩后反流误吸、低氧血症和喉罩染血的发生情况以及术后24小时内咽痛、声音嘶哑、吞咽困难、口腔黏膜损伤等并发症的发生情况差异均无显著性(P>0.05)。M组的气道密封压为(28.69±3.10)cm H2O,明显高于S组的(23.49±3.50)cm H2O,差异有显著性(P<0.05);M组的喉罩对位准确率(91%)也明显高于S组(71%),差异有显著性(P<0.05)。结论鸣人喉罩可以安全、有效地应用于乳腺整形手术的气道管理。 Objective To compared the efficiency of LMA MingRen and Supreme in providing an adequate and safe ventilation for breast plastic surgery. Method 70 patients undergoing breast plastic surgery under general anesthesia were randomly divided into two groups：MingRen group （group M） and Supreme group （group S）. The success rate of first insertion, insertion time, airway sealing pressure, peak airway pressure were recorded and the rate of correct position was confirmed by fiberoptic laryngoscopy. After removal of LMA, extubation time and the occurrence of regurgitation, hypoxemia and blood-staining were recorded. The occurrence of sore throat, hoarseness, dysphagia and mouth mucosal injury was also recorded within 24h after surgery. Result All patients of two groups were successfully inserted with LMA. There were no significant differences in terms of the success rate of first insertion, insertion time, peak airway pressure, extubation time, regurgitation, hypoxemia, blood-staining on LMA and sore throat, hoarseness and dysphagia between the two groups （P＆gt;0.05）. The airway sealing pressures of group M and group S were （28.69±3.10） cmH2O and （23.49±3.50） cmH2O （P〈0.05）, the rates of correct position under fiberoptic assessment were 91% and 71% （P〈0.05）. Conclusions LMA MingRen can safely and effectively be applied for airway management of breast plastic surgery.

关 键 词： 喉罩 鸣人喉罩 全身麻醉 乳腺整形手术