I-gel喉罩联合Coopdech支气管封堵器在胸科手术中的应用

发布时间：2018-06-03 00:51

本文选题：I-gel喉罩 + 支气管封堵器　；参考：《临床麻醉学杂志》2015年06期

【摘要】：目的探讨I-gel喉罩联合Coopdech支气管封堵器用于胸科手术中的安全性和可行性。方法选择60例全麻下行开胸手术患者,年龄20~65岁,ASAⅠ或Ⅱ级,随机分为两组,I-gel喉罩联合Coopdech支气管封堵器组(I组)和气管导管联合Coopdech支气管封堵器组(T组)。分别记录患者麻醉诱导前(T0)、麻醉诱导后(T1)、插入喉罩或气管导管即刻(T2)、手术结束时(T3)、拔除喉罩或气管导管即刻(T4)的MAP、HR;记录拔除喉罩或气管导管时间及苏醒时间,记录两组肺萎陷评分,记录两组单肺通气前、中及后的气道峰压(P1、P2和P3);记录术后肺不张以及呛咳、咽喉疼痛、声音嘶哑等的发生情况。结果与T组比较,T2、T4时I组MAP明显降低,HR明显减慢(P0.05);I组拔管时间和苏醒时间明显短于T组(P0.05),肺萎陷评分两组差异无统计学意义;术后两组均无肺不张;与T组比较,I组P1、P2和P3差异无统计学意义,但术后呛咳、咽喉疼痛、声音嘶哑等不良反应明显减少(P0.05)。结论 I-gel喉罩联合Coopdech支气管封堵器用于胸科单肺通气时,气道密封性可靠,通气效果好。
[Abstract]:Objective to investigate the safety and feasibility of I-gel laryngeal mask combined with Coopdech bronchial occluder in thoracic surgery. Methods A total of 60 patients, aged 20 to 65 years, who underwent thoracotomy under general anesthesia, were randomly divided into two groups: group I (group I) treated with I-gel laryngeal mask combined with Coopdech bronchial occluder (group I) and group T (tracheal duct combined with Coopdech bronchooccluder). The MAPHRs of T0 and T1 were recorded before and after anesthesia induction, respectively, and the time of removing laryngeal mask or trachea catheter and the recovery time were recorded, and T2 was inserted into larynx mask or tracheal catheter immediately after operation, and the MAPHRs of T3 and T4 were removed at the end of operation, respectively, and the time of removing larynx mask or tracheal catheter and the recovery time were recorded. Lung collapse scores were recorded, peak airway pressure before, during and after single lung ventilation in both groups were recorded, and the incidence of atelectasis, cough, throat pain and hoarseness were recorded. Results compared with group T, the MAP of group I was significantly lower than that of group T, and the time of extubation and recovery in group I was significantly shorter than that in group T (P 0.05), but there was no significant difference between the two groups in the score of lung atrophy, and no atelectasis was found in both groups after operation. There was no significant difference in P _ (1) P _ (2) and P _ (3) as compared with that in T group, but the adverse reactions such as cough, sore throat and hoarseness were significantly decreased after operation. Conclusion when I-gel laryngeal mask combined with Coopdech bronchial occluder is used for single lung ventilation in chest department, the airway seal is reliable and the ventilation effect is good.
【作者单位】：安徽医科大学附属省立医院麻醉科;
【基金】：安徽省自然科学基金项目(编号:11040606M169)
【分类号】：R614

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