Supreme双腔喉罩对右颈总动脉与颈内静脉相对解剖位置的影响

发布时间：2018-05-25 20:01

本文选题：喉罩 + 右颈内静脉　；参考：《临床麻醉学杂志》2015年11期

【摘要】：目的观察和比较Supreme双腔喉罩与气管插管对右颈总动脉和颈内静脉相对解剖位置的影响,测量喉罩置入后右颈内静脉相对安全穿刺角度。方法择期全身麻醉患者80例,随机分为两组,喉罩组(L组)和气管插管组(I组),每组40例。分别在环状软骨水平(Cricoid-Level)及颈动脉三角顶点水平(Triangle-Level)测量患者喉罩或气管导管置入前后颈内静脉与颈总动脉水平重叠距离(a)、右颈总动脉横径(b)、二者水平重叠率(a/b)、颈内静脉内径(DIJV)、颈内静脉穿刺角度(θIJV)、颈内静脉穿刺相对安全角度(RPA)、颈总动脉穿刺角度(θCCA)。结果 I组气管导管置入前后,环状软骨水平及颈动脉三角顶点水平a/b、DIJV、θIJV、RPA、θCCA差异无统计学意义。L组Supreme双腔喉罩置入前后环状软骨水平及颈动脉三角顶点水平θIJV差异无统计学意义,DIJV、a/b较置入前明显增大,θCCA、RPA较置入前明显减小(P0.05)。喉罩置入后环状软骨水平a/b增加46%,RPA相应减小11°,颈动脉三角顶点水平a/b增加38%,RPA相应减小10°。结论气管插管对颈总动脉与颈内静脉相对解剖位置无明显影响。Supreme双腔喉罩置入后增加了颈总动脉与颈内静脉重叠率,颈内静脉穿刺相对安全角度较正常情况下减少10°,增大了误穿动脉的可能性,不利于常规方法行颈内静脉穿刺置管。
[Abstract]:Objective to observe and compare the influence of Supreme double lumen laryngeal mask and tracheal intubation on the relative anatomical position of the right common carotid artery and the internal jugular vein, and to measure the relative safe puncture angle of the right internal jugular vein after the placement of the laryngeal mask. Methods Eighty patients with selective general anesthesia were randomly divided into two groups: laryngeal mask group (L group) and tracheal intubation group (40 cases in each group). The horizontal overlap distance between the internal jugular vein and the common carotid artery before and after the placement of the laryngeal mask or tracheal catheter was measured at the level of the annular cartilage (Cricoid-Levell) and the top of the carotid triangle (Triangle-Levell). The internal diameter of the vein was DIJV, the angle of internal jugular vein puncture (胃 IJV), the relative safe angle of internal jugular vein puncture, the angle of common carotid artery puncture (胃 CCA). Results in group I, tracheal catheter was placed before and after implantation. There was no significant difference in the level of annular cartilage and the level of carotid triangle vertex a / b, 胃 IJV, RPA, 胃 CCA. In group L, there was no significant difference in the level of annular cartilage before and after double lumen laryngeal mask implantation and the level of 胃 IJV at the top of the triangle of carotid artery. , 胃 CCAN RPA decreased significantly compared with that before implantation. After laryngeal mask implantation, the RPA of annular cartilage increased by 46 掳and RPA decreased by 11 掳, and the level of a / b increased by 38 掳at the top of the triangle of the carotid artery, and the RPA decreased by 10 掳. Conclusion tracheal intubation has no significant effect on the relative anatomical position of common carotid artery and internal jugular vein. The overlap rate of common carotid artery and internal jugular vein is increased after the placement of double lumen laryngeal mask. The relative safe angle of internal jugular vein puncture was 10 掳less than that under normal condition, which increased the possibility of perforating the artery by mistake, and was unfavorable to the routine method of internal jugular vein puncture and catheterization.
【作者单位】：中国医科大学附属第一医院麻醉科;辽宁省肿瘤医院麻醉科;
【分类号】：R614

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