超声辅助下喉罩定位用于腹腔镜手术的对比研究

Comparative study of ultrasound-assisted laryngeal mask positioning for laparoscopic surgery

目的观察超声定位喉罩位置在腹腔镜手术中的应用效果。方法选取我院2017年9月1日~2018年8月31日期间腹腔镜胆囊切除手术患者60例,随机分为对照组和试验组各30例。对照组全麻诱导插入喉罩后传统方法定位,试验组全麻诱导插入喉罩后采用超声定位。比较两组患者定位成功后的气道密封压、术中不同时间点的气道峰压(Ppeak)和呼末二氧化碳分压(PetCO2)以及观察和记录术中胃肠胀气和术后患者咽喉痛等并发症的发生率并比较。结果两组皆能安全地完成手术,试验组的呼吸道密封压明显高于对照组(P<0.05),气腹前(T1)及气腹后(T3)两组呼吸力学参数差异无统计学意义(P>0.05),气腹后10min(T2),两组患者Ppeak和PetCO2较气腹前及气腹后明显升高且对照组升高更明显,差异具有统计学意义(P<0.05),试验组在术中胃肠胀气方面发生明显少于对照组(P<0.05)。结论超声应用于喉罩定位成年患者喉罩位置效果较好,有利于提高喉罩通气的质量。

Objective To observe the effect of ultrasonic positioning of laryngeal mask position in laparoscopic surgery.Methods 60 patients with laparoscopic cholecystectomy from September 1,2017 to August 31,2017 in Yuyao People's Hospital were selected.They were randomly divided into control group and experimental group.The control group was treated with traditional method positioning after induction of general anesthesia and laryngeal mask insertion.The experimental group was treated with ultrasound positioning after induction of general anesthesia and laryngeal mask insertion.Airway sealing pressure after successful positioning,airway peak pressure(Ppeak)and end-tidal carbon dioxide partial pressure(PetCO2)at different time points during operation between two groups were compared.The flatulence during operation and postoperative patient's throat pain were observed,recorded and compared.Results Both groups could safely complete the operation.The respiratory sealing pressure of the experimental group was significantly higher than that of the control group(P<0.05).There was no significant difference between the pre-pneumoperitoneum(T1)and the post-pneumoperitoneum(T3)respiratory mechanical parameters(P>0.05).At 10 min(T2)after pneumoperitoneum,Ppeak and PetCO2 in the two groups were significantly higher than those in the pre-pneumoperitoneum(T1)and the post-pneumoperitoneum(T3).Ppeak and PetCO2 of the control group increased significantly,and the difference was statistically significant(P<0.05).The flatulence of the operation in the experimental group was significantly less than that of the control group(P<0.05).Conclusion Ultrasound applied in laryngeal mask positioning adult patients has good effect on laryngeal mask position,which is beneficial to improve the quality of laryngeal mask ventilation.