双管喉罩在老年无痛纤维支气管镜检查中的应用

Application of Laryngeal Mask in Painless Elderly Fiberoptic Bronchoscopy Patients

目的探讨喉罩通气施行无痛纤维支气管镜检查在老年患者中的可行性。方法 90例无痛纤维支气管镜检查和治疗的老年患者随机分为三组,均在地佐辛加丙泊酚麻醉下行纤维支气管镜检查和治疗,分别采用鼻导管给氧(鼻导管组)、内镜面罩吸氧(面罩组)和双管喉罩控制通气(喉罩组),比较三组患者SPO2下降的例数和低于85%的次数,麻醉时间和检查时间,术后由手术医师评价麻醉满意度。结果面罩组和喉罩组患者在出现SPO2降低的发生率与鼻导管组比较明显较低(P<0.05,P<0.01),SPO2降低发生率面罩组和喉罩组比较也存在明显差异(P<0.05)。出现SPO2≤85%次数面罩组和喉罩组也明显低于鼻导管组(P<0.05);面罩组和喉罩组的麻醉时间和检查时间均明显短于鼻导管组患者(P<0.05);术者满意度面罩组和喉罩组显高于鼻导管组(P<0.05,P<0.01)。结论无痛纤维支气管镜检查应用双管喉罩控制通气,提高老年患者检查的耐受性和安全性,是一种值得推广的气道管理手段。

Objective To discuss the feasibility of painless laryngeal mask airway fiberoptic bronchoscopy and treatment in elderly patients.Methods 90 cases of painless fiberoptic bronchoscopy and treatment of elderly patients were randomly divided into three groups.Three groups fiberoptic bronchoscopy and treatment assisted by Dezocine plus Propofol anesthesia,using a nasal catheter to oxygen（nasal catheter group）,endoscopic oxygen mask（mask group） and two pipe laryngeal mask airway control（laryngeal mask group） respectively.Three groups were compared in patients with SPO2 drop the number of cases and the times less than 85%,duration of anesthesia and inspection time,and postoperative evaluation by the surgery anesthesia satisfaction.Results Patients in incidence of SPO2 in mask group and laryngeal mask group was significantly lower than those in nasal catheter group（P〈0.05,P〈0.01）.Patients in incidence of SPO2 in mask group and laryngeal mask group was different（P〈0.05）.The number of SPO2 ≤ 85% in mask group and laryngeal mask group was lower than those in nasal catheter group（P〈0.05）.Anesthesia time and inspection time in mask group and laryngeal mask group were significantly shorter than those in nasal catheter group（P〈0.05）.Patients satisfaction in mask group and laryngeal mask group was significantly higher than those in nasal catheter group（P〈0.05,P〈0.01）.Conclusion Painless fiberoptic bronchoscopy using a tube laryngeal mask airway control,this method can improve the elderly patients tolerated and safety check,this method is also a worth promoting airway management means.