喉罩在基层医院麻醉与急救复苏中的应用研究

The application of laryngeal mask airway in primary hospital-based anesthesia and urgent resuscitation

目的探讨喉罩在基层医院麻醉与急救复苏中的临床应用。方法将我院2009年6月至2010年6月收治的因各种原因导致呼吸衰竭或停止且需行手术治疗的患者按人院时的排序单双号分为观察组和对照组，每组40例。观察组采用喉罩通气麻醉，对照组采用气管插管麻醉，比较两组患者的插管困难程度，麻醉诱导前（To，基础值）、诱导后（T1）、插管（或置喉罩）后即刻（T2）、插管（或置喉罩）后5min（T，）、10min（T4）时的心率（HR）、收缩压（SPB）、舒张压（DPB）变化。结果观察组患者均一次插管成功，成功率为100％，对照组一次插管成功32例，成功率为80．0％，且观察组的插管难度要显著优于对照组，P〈0．05。观察组患者置喉罩前后血压、心率及无明显变化，P〉0．05；对照组患者气管插管后血压升高、心率增快，P〈0．05。结论喉罩操作简单，可盲探插管，有利于急救复苏，且应有于麻醉也较为安全可靠。

Objective To investigate the application of laryngeal mask airway in primary hospital-based anesthesia and urgent resuscitation. Methods 80 patients with respiratory failure or arrest due to various causes who had been hospitalized during the period of June 2009 to June 2010 to receive surgery were randomly assigned to receive laryngeal mask airway anesthesia（ 40 patients, study group ）, or endotracheal intubation anesthesia （ 40 patients, control group ）. The difficulty degree of intubation, and heart rate （ HR ）, systolic blood pressure （ SBP ）, and diastolic pressure （ DBP ） at pre-induction of anesthesia （ TO, baseline ）, post-induction （ T1 ）, the moment of intubation or placement of laryngeal mask airway （ T2 ）, 5 min （ T3 ） or 10 rain （ T4 ） after intubation or placement of laryngeal mask airway were compared between the two groups, Results Intubation was much easier in the study group than in the control group （ P〉 0.05 ）. BP and HR did not change significanlty in the study group after placement of laryngeal mask airway （ P〉 0.05 ） while they increased in the control group after tracheal intubation （ P 〈 0.05 ）. Conclusion Placement of laryngeal mask airway is simple, reliaable, and safe and is ben- efieial for urgent resuscitation.