三通喉罩用于犬支气管肺灌洗术对血流动力学和呼吸功能的影响

Effects of three-way laryngeal mask airway on canine hemodynamics and respiratory function during bronchoalveolar lavage

目的研究三通喉罩(TLMA)与气管导管(TC)通气用于犬支气管肺灌洗术(BAL)对血流动力学和呼吸功能的影响。方法 20只成年犬随机分为TLMA组(T组,n=10)和TC组(C组,n=10),在全身麻醉下实施BAL术。记录麻醉诱导前(T0)、插入TLMA/TC前(T1)、插入TLMA/TC即刻(T2)、插入TLMA/TC通气3 min(T3)、10 min(T4)、实施BAL 10 min(T5)、20 min(T6)、30 min(T7)、拔除TLMA/TC即刻(T8)和拔除TLMA/TC后3 min(T9)的SpO2、SBP、DBP和HR;记录T2、T3、T4、T5、T6、T7的潮气量(VT)、气道峰压(Ppeak)及呼气末二氧化碳分压(PETCO2)。结果 C组T2、T3、T8时SBP、DBP和HR显著高于T组(P<0.05);C组Ppeak在T5、T6、T7显著高于T组(P<0.05)。结论在犬BAL中,使用TLMA或者TC通气都是安全有效的,TLMA通气优于TC通气,血流动力学更稳定。

Objective To study the effects of three-way laryngeal mask airway （TLMA）and tracheal catheter（TC） on canine hemodynamics and respiratory function during bronchoalveolar lavage（BAL）. Methods Twenty adult dogs were randomly divided into TLMA （ group T, n = 10） and TC （ group C, n = 10）. BAL was carried out under general anesthesia, SpO2, SBP, DBP, and HR were measured before the anesthesia induction （ T0 ） , before the insertion of TLMA or TC （ T1 ）, at the moment of TLMA or TC insertion （ T2 ） , at the 3rd（ T3 ） and 10th（ T4 ） minutes, 10 （ T5 ） ,20 （ T6 ）, and 30 （ T7 ） minutes after BAL carried out, at the moment of TLMA or TC extubation（ Ts ）, and 3 minutes after the TLMA or TC extubation （ T9 ）. The tidal volume （ VT）, peak airway pressure （ Ppeak）, and partial pressure of carbon dioxide in endexpiratory gas （ PETCO2 ） were recorded at T2,T3, T4, Ts, T6, and T7. Results In group C, SBP, DBP, and HR were significantly higher than those in group T at T2, T3 , and Ts （ P 〈 0.05 ）. In group C, Ppeak was significantly higher than that in group T at T5 , T6, and T7 （ P 〈 0.05 ）. Conclusion During BAL, the application of TLMA or TC is safe and effective. However, ventilation through TLMA is superior to that through TC because of more stable hemodynamics.