双腔喉罩在脑动脉瘤微弹簧栓塞术中的应用研究

Application of Double-lumen Laryngeal Mask in Micro-spring Embolization of Cerebral Aneurysm

【目的]探讨双腔喉罩（ProSealLMA）在脑动脉瘤微弹簧栓塞术中应用的安全性和可行性。【方法]40例择期或急症脑动脉瘤微弹簧栓塞术患者，ASAI～Ⅲ级，年龄21～69岁，随机均分为气管导管组（T组）和ProSeal喉罩组（P组）。观察患者麻醉前10min（T1）、插管（罩）后1min（T2）、插管（罩）后5min（T3）、拔管（罩）时即刻（T4）的心率（HR）、血压（BP）、脉搏血氧饱和度（SpO2）、呼气末二氧化碳分压（PETCO2），在T1、T3和T4分别抽取动脉血进行血气分析，在插管（罩）前和在拔管（罩）后进行胃张力评分，记录麻醉时间、术后并发症和全麻用药量。【结果】两组患者一般情况、术中通气情况、血气分析及胃张力变化差异均无统计学意义。T组较P组插拔管（罩）时循环系统波动大（P〈0．05）且拔管时呛咳发生率高（P〈0．01）、术后咽痛发生率高（P〈0．05）、全麻用药量大（P〈0．05）。【结论】双腔喉罩可安全有效地应用于脑动脉瘤微弹簧栓塞术。

[Objective] To explore the safety and feasibility of the application of double-lumen laryngeal mask（ProSeal LMA） in micro-spring embolization of cerebral aneurysm. [Methods] Forty ASA I - III pa- tients aged from 21 to 69 years old undergoing elective or emergency operations of micro-spring embolization of cerebral aneurysms were randomly divided into the endotracheal tube group（group T） and the ProSeal LMA group（group P）. Heart rate（HR）, blood pressure（BP）, SpO2, PETCO2 Of patients were observed before anesthesia 10min（T1 ） , intubation（LMA） after lmin（T2 ）, intubation（LMA） after 5min（T3 ）, immediate extubation（LMA） （T4）. In Tl , T3 and T4 respectively, arterial blood was obtained for gas analysis. Gastric motility score was compared between before and after operation. The time of anesthesia, complications and dosage of narcotic were recorded. [Results] There were no significant differences in general conditions, intraoperative ventilation conditions and changes in blood gas analysis and gastric motility between two groups. The larger fluctuations in the circulatory system were seen in group T than those in group P（ P 〈0.05）. The incidence of cough and postoperative sore throat were higher in group T than those in group P（ P 〈0. 01, P 〈0.05）. The consumption of anesthetics in group T was larger than in that in group P（ P 〈0. 05）. [Conclusion] The ProSeal LMA can be safely and effectively used in micro spring embolization of cerebral aneurysm.