I-gel喉罩在老年无牙齿患者全身麻醉中通气效果的临床观察

发布时间：2018-11-04 13:10

【摘要】：目的通过与牙齿正常老年患者的喉罩通气效果比较,观察I-gel喉罩在老年无牙齿患者全身麻醉中的应用效果,从而为临床提供参考。方法此次研究中,选择60例在全麻下行腹股沟疝修补术的老年男性患者作为实验研究对象,均为杭州师范大学附属医院于2014年5月—2015年5月期间所接收,分为无牙齿组(NT组)和正常组(T组),每组30例,根据体重选择喉罩型号,麻醉诱导后置入喉罩,进行机械通气。记录诱导前(T0)、置入喉罩后即刻(T1)、3 min(T2)及拔出喉罩前(T3)、拔出后即刻(T4)、3 min(T5)患者平均动脉压和心率;记录2组喉罩的置入时间、置入次数、纤支镜对喉罩对位的分级、气道密封压、相关并发症及血气分析;比较手术前后患者的通气效果。结果 NT组的喉罩置入时间及置入次数多于T组,但差异无统计学意义(P0.05);2组的喉罩置入成功率、喉罩对位情况、气道密封压及漏气情况差异无统计学意义(P0.05);2组患者置入和拔出喉罩时的血流动力学平稳,且其他并发症2组间差异无统计学意义(P0.05)。结论 I-gel喉罩通气置入后与喉周组织呈镜像吻合,有效减少对喉周组织的压迫,为老年患者提供更安全的麻醉环境。并可有效预防老年无牙齿患者全麻术中因通气所引起的血流动力学的波动,降低术中不良事件的发生率,在临床中具有重要的作用。
[Abstract]:Objective to observe the application of I-gel laryngeal mask in general anesthesia of elderly patients without teeth by comparing the effect of laryngeal mask ventilation with that of the elderly patients with normal teeth, so as to provide reference for clinical practice. Methods in this study, 60 elderly male patients undergoing inguinal herniorrhaphy under general anesthesia were selected as experimental subjects, all received from May 2014 to May 2015 in the affiliated Hospital of Hangzhou normal University. There were 30 cases in each group. According to body weight, laryngeal mask type was selected, and the laryngeal mask was placed after anesthesia induction and mechanical ventilation was carried out. The mean arterial pressure and heart rate were recorded before induction (T0), immediately after placement of laryngeal mask (T1), 3 min (T2) and before pulling out laryngeal mask (T3), immediately after pullout (T4) and 3 min (T5). The time and times of laryngeal mask placement, the classification of laryngeal mask, airway seal pressure, related complications and blood gas analysis were recorded, and the ventilation effect of patients before and after operation was compared. Results the laryngeal mask implantation time and times in NT group were more than that in T group, but the difference was not statistically significant (P0.05). There was no significant difference in the success rate of laryngeal mask placement, the position of laryngeal mask, the airways seal pressure and air leakage in the two groups (P0.05). The hemodynamics of the two groups was stable when the laryngeal mask was inserted and pulled out, and there was no significant difference in other complications between the two groups (P0.05). Conclusion I-gel laryngeal mask is mirrored anastomosis with perilaryngeal tissue after ventilation, which can effectively reduce the compression of perilaryngeal tissue and provide a safer anaesthesia environment for elderly patients. It can effectively prevent hemodynamic fluctuation caused by ventilation and reduce the incidence of adverse events during general anesthesia in elderly patients without teeth, which plays an important role in clinical practice.
【作者单位】：杭州师范大学附属医院麻醉科;
【分类号】：R614.2

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