双管喉罩在急救复苏中的临床应用

Clinical application of proseal laryngeal mask airway in first-aid resuscitation

目的研究双管喉罩在成年患者急救复苏中应用的临床效果。方法40例成年患者随机分为双管喉罩组和气管插管组,分别观察记录插管次数、插管耗时、插管前(T_1)、插管即刻(T_2)、插管后1 min(T_3)、插管后5 min(T_4)、插管后10 min(T_5)、拔管即刻(T_6)的收缩压、舒张压和心率,同时记录患者插管、拔管和维持通气过程中的呼吸并发症和呼吸道损伤情况。结果2组插管次数和插管耗时差异无统计学意义;气管插管组T_2、T_3、T_6收缩压、舒张压和心率均高于双管喉罩组(P<0.05);气管插管组T_2、T_3、T_6收缩压、舒张压和心率较T_1显著增加(P<0.05);双管喉罩组T_1～T_6收缩压、舒张压和心率无变化(P>0.05);气管插管组呼吸并发症和呼吸道损伤情况多于双管喉罩组。结论双管喉罩在成年患者的急救复苏中临床效果优于气管插管,可维持血流动力学稳定,应激反应轻微,减少了呼吸并发症的发生。

Objective To study the clinical effects of proseal laryngeal mask airway in first-aid resuscitation. Methods 40 adult patients were randomly divided into two groups： laryngeal mask airway group and tracheal intubation group. The number of intubation and the time spent by intubation were records. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and heart rate （HR） were recorded before intubation （T1）, during intubation （T2）, i min after intubation （T3）, 5 rain after intubation （T4）, 10 min after intubation （T5） and during extubation （T6）. The respiratory complications and respiratory damage were recorded during intubation, extubation, and the maintenance of ventilation process. Results The number and time of intubation had no difference between the two groups. In tracheal intubation group, SBP, DBP and HR were significantly higher than those in two-laryngeal mask airway group at T2, T3 and T6 （P 〈0.05）; SBP, DBP and HR in tracheal intubation group were significantly increased at T2, T3, and T6 （P 〈0.05）. SBP, DBP and HR in proseal laryngeal mask airway group were not significantly increased at T2, Ta and T6 （P 〈0.05）. Respiratory complications and respiratory damage were significantly higher in tracheal intubation group than in proseal laryngeal mask airway group. Conclusion Proseai laryngeal mask airway is superior to tracheal intubation in first-aid resuscitation of adult patients, it can keep stable hemodynamics, produce less stress responses and lower respiratory complications.