一次性双管喉罩在气道高反应性患者全麻苏醒期中的应用效果

Application effect of disposable double tube laryngeal mask in patients with airway hyperresponsiveness during general anesthesia recovery period

目的探讨一次性双管喉罩在气道高反应性患者全麻苏醒期中的应用效果。方法选取2016年3月～2017年3月河北省保定市第二医院收治的气道高反应性患者94例,采用随机数字表法将其分为观察组与对照组,每组47例。对照组应用气管导管治疗,观察组应用一次性双管喉罩治疗。观察并比较两组患者血流动力学、术后苏醒质量以及不良反应发生率。结果拔除气管导管或喉罩前(T2)、拔除气管导管或喉罩即刻(T3)、拔除气管导管或喉罩5 min(T4)时,观察组患者收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)均明显低于对照组,差异有统计学意义(P <0.05)。麻醉诱导前(T1)、T2、T3、T4时,两组患者脉搏血氧饱和度(SpO2)、动脉血二氧化碳分压(PaCO2)比较,差异无统计学意义(P> 0.05)。两组患者自主呼吸恢复时间、呼之睁眼时间、意识完全恢复时间以及拔除喉罩或气管导管时间比较,差异无统计学意义(P> 0.05);而观察组出室时Steward苏醒评分明显高于对照组,差异有统计学意义(P <0.05)。观察组患者总不良反应发生率为10.64%,明显低于对照组的29.79%,差异有统计学意义(P <0.05)。结论气道高反应性患者全麻苏醒期应用一次性双管喉罩可明显改善患者的血流动力学,提高术后苏醒质量,降低不良反应发生率,保证患者安全。

Objective To explore the application effect of disposable double tube laryngeal mask in patients with airway hyperresponsiveness during general anesthesia recovery period.Methods Ninety-four patients of airway hyperresponsiveness treated in the Second Hospital of Baoding of Hebei Province from March 2016 to March 2017 were selected and divided into the observation group and the control group by random number table method,with 47 cases in each group.The control group was treated with tracheal intubation,the observation group was treated with disposable double tube laryngeal mask.The hemodynamics,postoperative recovery quality and incidence of adverse reactions were observed and compared between the two groups.Results The levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR)before extubation of trachea or laryngeal mask(T2),at extubation of tracheal ductus or laryngeal mask(T3),5 min of extubation of tracheal ductus or laryngeal mask(T4)in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the level of pulse oxygen saturation(SpO2)and partial pressure of carbon dioxide in artery(PaCO2)before induction of anesthesia(T1),T2,T3,T4 between the two groups(P>0.05).There was no significant difference in the time of spontaneous breathing recovery,the time of eye opening,the time of full recovery of consciousness,and the time of extraction of the laryngeal mask or tracheal intubation between the two groups(P>0.05);while the Steward awakening score of the observation group was significantly higher than that of control group,the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 10.64%,which was significantly lower than that in the control group(29.79%),the difference was statistically significant(P<0.05).Conclusion The use of disposable double tube laryngeal mask in patients with airway hyperresponsiveness during general anesthesia recovery period can obviously improve the hemodynamics of the patients,improve the quality of postoperative recovery,reduce the incidence of adverse reactions and ensure the safety of the patients.