SLIPA喉罩用于纤维支气管镜检查的肺通气效果观察

Observation of lung ventilation effects in bronchoscopy with streamlined liner pharynx airway

目的采用自身对照设计方法比较咽通气道衬垫(streamlined liner of the pharynx airway,SLIPA)喉罩在置入纤维支气管镜前后机械通气的有效性。方法选择25例美国麻醉医师协会(American Society of Anesthesiologists,ASA)体格状况分级Ⅰ-Ⅱ级,拟在全身麻醉下行下肢内固定取出术的患者,在常规诱导后插入SLIPA喉罩。检查无漏气,位置满意后,通过Y型接头接呼吸机,将潮气量设为10 ml/kg,实施容量控制强制通气模式(CMV)。记录此后连续5次呼吸的平均吸气流速、呼气流速、吸气峰压、吸气气道阻力及气道的顺应性。再经Y型接头的吸痰口、以SLIPA喉罩为引导置入纤维支气管镜至气管隆突上方约1 cm处,再次记录此后连续5次呼吸的平均吸气流速、呼气流速、吸气峰压、吸气气道阻力及气道的顺应性。结果所有患者在置入纤维支气管镜前后均能获得良好的通气效果,平均吸气流速、呼气流速、吸气峰压、吸气气道阻力及气道的顺应性均无显著差异。结论 SLIPA喉罩可以为纤维支气管镜检查提供有效、安全、长时间的通气支持。

Objective To compare the effect of the Streamlined liner pharynx airway（SLIPA） pre-and post-ventilation with a randomized auto control design.Methods Twenty five patients with ASAⅠorⅡ,scheduled for internal fixation dislodgment surgery in lower limb under general anesthesia.After the routine intravenous anesthesia induction,the SLIPA were inserted.To connect respirator by a Y-shaped joint after checking the airway seal and location is satisfactory.The mean inspired flow,expired flow,peak inspiratory pressure,airway resistance and airway compliance of five continuous breaths were measured after CMV＋ ventilation strategy with 10 ml/kg tidal volume were enforced.Then bronchoscopy were inserted and situated 1cm above the tracheal carina with SLIPA for the guide by the Y-shaped joint.The mean expired flow,inspired flow,peak inspiratory pressure the mean airway resistance and airway compliance of five continuous breaths were measured again.Results Adequate ventilation were obtained in all patients pre-and post-insertion of SLIPA.The mean expired flow,inspired flow,peak inspiratory pressure,airway resistance and airway compliance did not show significant difference.Conclusion SLIPA is safe and effective ventilation that can be used in bronchoscopy for long time.