快速康复理念指导下I-gel喉罩联合Tappa支气管封堵器在肺癌根治术患者中的应用效果

Application Effect of I-gel Laryngeal Mask Combined with Tappa Bronchial Occluder in Patients Undergoing Radical Resection of Lung Cancer under the Guidance of Enhanced Recovery after surgery

目的:评价快速康复理念(ERAS)指导下I-gel喉罩联合Tappa支气管封堵器在肺癌根治术患者中的应用效果。方法:选取2020年12月—2022年9月山东省乳山市人民医院拟行胸腔镜单侧肺癌根治术患者60例为研究对象,根据随机数字表法分为观察组(采用I-gel喉罩联合Tappa支气管封堵器通气)和对照组(采用双腔气管插管通气),各30例。比较两组呼吸动力学、血流动力学指标及并发症发生率。结果:麻醉前、术后30 min、术毕拔管时,两组平均动脉压比较,差异无统计学意义(P>0.05)。观察组单肺通气时气道峰压、动脉血氧分压高于对照组,动脉血二氧化碳分压低于对照组,差异有统计学意义(P<0.05)。术毕拔管后,观察组咽喉痛的发生率低于对照组,差异有统计学意义(P<0.05)。结论:ERAS指导下I-gel喉罩联合Tappa支气管封堵器是一种较有效的单肺通气方法,可以在肺癌根治术患者中应用,安全性较高。

Objective:To evaluate the application effect of I-gel laryngeal mask combined with Tappa bronchial occluder in patients undergoing radical resection of lung cancer under the guidance of enhanced recovery after surgery(ERAS).Methods:From December 2020 to September 2022,sixty patients who planned to undergo thoracoscopic unilateral radical resection of lung cancer in Rushan People's Hospital,Shandong Province were selected as the research objects.According to the random number table method,they were divided into observation group(ventilated by I-gel laryngeal mask combined with Tappa bronchial occluder)and control group(ventilated by double-lumen endotracheal intubation),with thirty cases in each group.The respiratory dynamics,hemodynamic indexes and incidence of complications were compared between the two groups.Results:Before anesthesia,30 minutes after operation,and extubation after operation,there was no significant difference in mean arterial pressure between the two groups(P>0.05).The peak airway pressure and partial pressure of arterial blood oxygen in the observation group during one-lung ventilation were higher than those in the control group,and the partial pressure of carbon dioxide in arterial blood was lower than that in the control group,and the difference was statistically significant(P<0.05).After extubation,the incidence of sore throat in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Under the guidance of ERAS,I-gel laryngeal mask combined with Tappa bronchial occluder is an effective method of one-lung ventilation,which can be applied in patients with lung cancer undergoing radical resection,with high safety.