Flexible LMA在鼻内镜手术中应用的气道安全性

Airway safety of application of flexible laryngeal mask airway in endoscopic sinus surgery

目的:探讨与气管插管相比,Flexible LMA(flexible laryngeal mask airway)在全麻下鼻内镜手术(endoscope si-nus surgery,ESS)中的应用的安全性。方法:选取择期行ESS手术的成年患者60例,将其随机分为F组和T组,每组各30例。观察Flexible LMA的密闭性,拔出喉罩后罩体血染情况,比较两组通气效果、呼吸容量环路及插入难易程度。结果:Flexible LMA漏气压力值在插入后和拔出前均较满意,颈部呼吸音听诊均清晰,拔出喉罩腹侧血染为1例;两组通气效果比较差异无统计学意义(P>0.05),F组各时点气道峰压均低于T组(均P<0.05);呼吸容量环路比较差异无统计学意义(P>0.05);F组置入时间低于T组(P=0.017)。结论:Flexible LMA与气管插管相比在ESS术中的应用是安全可行的。

Objective： To investigate the safety of application of flexible laryngeal mask airway（Flexible LMA） in endoscopic sinus surgery（ESS） compared with endotracheal intubation.Methods： 60 adult patients selected for EES were randomly divided into group F and group T,with 30 patients for each group.Observation items included the impermeability of the Flexible LMA,blood staining conditions of the laryngeal mask after extraction and ventilation effectiveness,respiratory capacity of the pressure loopy and the difficulty level of insertion between the two groups.Results： Impermeability of the Flexible LMA after insertion and before extraction was reliable.Auscultation showed clear neck breath sounds.One case of ventral blood stain occurred after extraction of the laryngeal mask.There was no significant difference between the two groups as to the ventilation effectiveness（P0.05）.The airway peak pressure of the group F was lower than that of the group T（P0.05）.There was no significant difference between the two groups as to the respiratory capacity of the pressure loopy（P0.05）.The insertion time of the group F was shorter than that of the group T（P=0.017）.Conclusion： Compared with endotracheal intubation,the application of Flexible LMA in endoscopic sinus surgery is safe and practicable.