Ⅰ-gel喉罩与标准喉罩用于肺大疱行微创手术气道管理效果的对照观察

Effects of the Ⅰ-gel laryngeal mask and the standard laryngeal mask on airway management in the patients with pulmonary bullous minimally invasive surgery

目的探讨Ⅰ-gel喉罩与标准喉罩用于肺大疱行微创手术气道管理效果。方法收集68例拟行微创手术的肺大疱患者,依据麻醉诱导后所选喉罩的类型分为实验组(Ⅰ-gel喉罩)和对照组(标准型喉罩)。记录两组患者首次插入的成功率、建立通气时间、气道密封压、纤维支气管镜的评级、术中调整喉罩位置的例数和术后相关并发症。结果实验组患者建立有效通气的时间、术中需要调整喉罩位置的例数均明显低于对照组(t=2.22,χ~2=7.05,P均<0.05);实验组首次置入喉罩成功率、喉罩置入后患者的口咽腔漏气压均明显高于对照组(χ~2=6.18,t=2.16,P均<0.05);实验组患者纤维支气管镜下声门暴露评级明显优于对照组(χ~2=5.82,P<0.05);两组患者术后并发症的发生率比较,差异无统计学意义(χ~2=3.63,P>0.05)。结论微创手术行肺大疱切除术中,Ⅰ-gel喉罩对患者的气道管理效果明显优于标准型喉罩,且不增加其并发症。

Objective To explore the effect of Ⅰ-gel laryngeal mask and the standard laryngeal mask on airway management in the patients with pulmonary bullous minimally invasive surgery. Methods Totally 68 cases who received minimally invasive surgery were collected and divided into the experimental group(the Ⅰ-gel laryngeal mask)and the control group(the standard laryngeal mask)according to the different type of laryngeal mask.The success rate of first insertion,the establish ventilation time,the airway sealing pressure,the rating of fiberoptic bronchoscopy,the number of cases of adjusting the laryngeal mask and the postoperative complication of the two groups were recorded. Results Compared to the control group,the establish effective ventilation time of the experimental group was lower,and the number of cases of adjusting the laryngeal mask during operation was less(t=2.22,χ^2=7.05,P<0.05).The successful rate of first insertion and the patient’s stoma leak pressure after the laryngeal mask of the experimental group was significantly higher than the control group(χ^2=6.18,t=2.16,P<0.05).The grade of glottis explosure under fiberoptic bronchoscope in the experimental group was significantly better than that in the control group(χ^2=5.82,P<0.05).The difference in incidence of postoperative complications between two groups was not statistically significant(χ^2=3.63,P>0.05). Conclusion The patient’s airway management effect of the Ⅰ-gel laryngeal mask is superior to the standard laryngeal mask in minimally invasive surgery,and do not increase the complications.