ALMA喉罩在乳腺外科全身麻醉术中临床效果的比较

Comparison of clinical effect of ALMA laryngeal mask on general anaesthesia breast operation

目的：比较将ALMA喉罩的两种置入方法用于乳腺外科手术全身麻醉中的效果。方法选取全身麻醉下行乳腺外科手术患者80例。随机数字表法分为标准正中置入喉罩组（ A组）和入口后部分充气侧方置入喉罩组（B组）。记录两组的一次置入成功率、置入时间、置入总成功率、气道压、口咽腔漏气压、术中需调整喉罩情况、术后咽痛和拔出喉罩沾有血迹情况，并观察有无其他并发症的发生。结果 A组和B组喉罩一次置入成功率、喉罩成功置入时间、咽痛及拔出喉罩沾有血迹的发生率，有统计学意义（ P 〈0.05）；两组的总成功率、气道压、口咽腔漏气压及术中需调整喉罩情况，无统计学意义（ P 〈0.05）。结论入口后部分充气侧方置入ALMA双管喉罩法，较传统标准正中置入法更为实用方便，一次置入成功率高，且置入时间更短，减少了术后咽痛和黏膜损伤并发症的发生，值得临床推广。

Objective To compare the effect of two implantation methods of ALMA laryngeal mask during the general anesthesia for breast operation. Methods Under general anesthesia, 80 cases of patients undergone the breast operation were randomly divided into standard median LMA group （ Group A） and partial aeration lateral LMA implantation after entrance group （Group B）. The success rate of first implantation, implantation time, implantation total success rate, airway pressure, pharyngo-oral cavity leak pressure, intraoperative adjustment of laryngeal mask, postoperative sore throat and bloodstain when laryngeal mask pulled out were recorded, meanwhile, the incidence of other complications were observed. Results Comparison between Group A and Group B, success rate of the first la-ryngeal mask implantation, laryngeal mask implantation time, sore throat occurrence rate and the incidence of blood-stain when laryngeal mask pulled out showed statistical significance （ P 〈0. 05）, however, the total success rate, airway pressure, pharyngo-oral cavity leak pressure and laryngeal mask adjusted during the operation indicated no statistical significance （ P 〈0. 05）. Oxygen desaturation, bronchial spasm, dysphagia, aspiration, bloating and hoarseness complications did not appear in two groups. Conclusion Compared with standard median LMA method, the method of partial aeration lateral LMA implantation after entrance is more convenient and practical than tradition-al method, which can improve the implantation success rate at first time, shorten implantation time, reduce the inci-dence of postoperative sore throat and mucosal injury complications, this method is worthy of clinical promotion.