通过喉罩行气管插管的两种方法比较

Comparison of Two Methods of Changing Laryngeal Mask

目的比较探条引导法和纤支镜引导法两种从喉罩更换气管导管的方法,探讨两种方法的安全性和操作的简便性。方法选择拟行气管插管全身麻醉的患者30例,随机分为两组,每组15例。Ⅰ组用探条法,Ⅱ组用纤支镜法。患者静脉麻醉后放置4号喉罩。Ⅰ组把探条和纤支镜同时放入喉罩通气管,将弹性探条穿过喉罩口经声门插入气管,将纤支镜和喉罩退出口腔,在弹性探条的引导下,插入气管导管。Ⅱ组用气管导管套于纤支镜上,纤支镜通过喉罩进入气管,把气管导管送入气管。记录开始更换导管到插气管导管成功的时间。术毕拔除气管导管。术后2h随访,记录咽痛等并发症。统计学分析用配对t检验和卡方检验。P<0.05为有显著性差异。结果Ⅰ组(探条法)和Ⅱ组(纤支镜法)患者一般情况无显著差异。所有患者都能成功更换气管导管。Ⅱ组更换气管导管的时间比Ⅰ组长(P<0.05)。两组的咽痛率无显著性差异。结论弹性探条引导法能够相对简便、快速地通过喉罩更换气管导管。

Objective Tocomparison methods of changing laryngeal mask（LMA） by gum elastic bougie（GEB） and fibreoptic bronchoscope（FOB） guide. To compare to safety and feasibility. Methods 30 patients were randomly allocated into 2 groups, 15 patients in each group. Group Ⅰis bougie guiding, group Ⅱ is FOB guiding. Laryngeal masks （size 4） were inserted. In group Ⅰ, bougie was inserted into trachea trough LMA. Endotrachea tube was inserted into trachea guided by bougie. In group Ⅱ, FOB inserted into trachea trough the LMA, the endotrachea tube was guided into trachea by the FOB. Time of changing LMA to endotrachea tube was recorded. Throat pain was recorded 2 hrs after extubation. Results All the patients success in intubating LMA and endotrachea tube. The time of changing endotrachea tube from LMA is longer in group Ⅱ than in group Ⅰ. There was no difference in rate of throat pain. Conclusion It is more rapid and easy to change endotrachea tube from LMA.