PLMA、SLIPA、PLMA用于腹腔镜手术患者气道管理的安全性及有效性观察

Analysis of the Safety and Effect of Pro Seal Laryngeal Mask Airway in Patients Undergoing Laparoscopic Surgery

目的探讨PLMA喉罩用于腹腔镜手术患者气道管理的安全性及有效性。方法将116例择期行腹腔镜手术的患者按照分层随机化分组法分为3组,分别为PLMA组、SLIPA喉罩组及CLMA组,观察3组血流动力学参数、气道密封效果、置管成功率及不良反应发生率。结果 3组喉罩置入成功率无显著差异(P>0.05),SLIPA组喉罩置入容易患者比例明显高于PLMA组和CLMA组(P<0.05)。3组气腹后气道吸气峰压(PIP)高于气腹前(P<0.05),PLMA组气腹前后的气道密封压小于PIP患者比例均显著低于SLIPA组和CLMA组(P<0.05)。3组各时间点平均动脉压(MAP)、心率(HR)及血氧饱和度(Sp O2)无显著差异(P>0.05)。3组喉痉挛、返流、咽喉痛等不良反应发生率无显著差异(P>0.05)。结论 3种喉罩均可安全应用于腹腔镜手术中,但腹腔镜手术适宜选择密封性更好的PLMA喉罩。

Objective To analyze the safety and effect of Pro Seal laryngeal mask airway in patients treated with laparoscopic surgery. Methods According to a stratified randomization method,116 cases of patients treated with laparoscopic surgery were divided into the laryngeal mash airway classic( CLMA) group,streamlined Liner of Pharyngeal Airway( SLIPA) group and laryngeal mask airway Pro Seal( PLMA) group,3 groups of hemodynamic parameters,airway sealing pressure,the success rate of catheterization and the incidence of adverse reactions were observed. Results There was no significant difference in the incidence of complications,the successful rate of catheterization and hemodynamic parameters among the 3 groups( P > 0. 05). The placement was easier and the placement time were significantly better in group SLIPA than in group PLMA and group CLMA( P <0. 05). When intra-abdominal pressure achieved 12 mm Hg,PIP was significantly higher in after pneumoperitoneum than before pneumoperitoneum in all the three groups( P < 0. 05). The airway sealing pressure was significantly higher in group PLMA than in group SLIPA and group CLMA( P < 0. 05),and the rate of patients with airway sealing pressure less than PIP was lower in group PLMA than in group SLIPA and group CLMA( P < 0. 05). Conclusion 3 kinds of laryngeal mask can be safely used in laparoscopic operation,the airway sealing pressure of Pro Seal laryngeal mask airway is best,it is most suitable for laparoscopic surgery.