下颌第二恒磨牙远中舌侧尖间距作为成人喉罩型号选择方法的可行性

发布时间：2018-03-03 04:21

本文选题：喉罩　切入点：型号　出处：《复旦学报(医学版)》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨下颌第二恒磨牙远中舌侧尖间距作为成人喉罩型号选择方法的可行性。方法选择使用喉罩行择期手术的患者68例,随机分为两组:标准体重(B组)和下颌第二恒磨牙远中舌侧尖间距(D组),每组34例,根据结果选择相应型号的喉罩。患者予全麻诱导,插入选定型号的喉罩。行喉罩漏气和纤支镜下对位检查,满意后行机械通气。术毕患者清醒后拔除喉罩,观察并记录喉罩上血丝情况。术后随访患者咽喉部并发症情况。结果 D组纤支镜下3和4级的例数(32例)多于B组(26例),差异有统计学意义(P0.05)。两组中纤支镜下1和2级行正压通气成功8例,失败2例,镜下3和4级行正压通气成功58例,无失败病例,纤支镜下分级与喉罩正压通气成功率之间有明显相关性(P0.05)。两组中同一患者按两种方法选择的型号不一致时,按B组方法选出的型号纤支镜下1和2级为5例,镜下3和4级为1例;按D组方法选出的型号纤支镜下无1级和2级病例,镜下3和4级为6例;两组差异有统计学意义(P0.05)。结论根据下颌第二恒磨牙远中舌侧尖间距选择喉罩型号的方法可增加喉罩插入后与声门最佳对合的概率,从而提高喉罩正压通气的成功率,在临床实践中具有可行性。
[Abstract]:Objective to explore the feasibility of using the distance between the distal lingual tip of mandibular second permanent molar as the method of selecting the type of laryngeal mask in adults. Methods 68 patients with laryngeal mask undergoing elective operation were selected. They were randomly divided into two groups: standard body weight group B) and mandibular second permanent molar group D, with 34 cases in each group. According to the results, the corresponding laryngeal mask was selected. The patients were induced by general anesthesia. Insert the selected type of laryngeal mask. Perform the laryngeal mask leak and fiberoptic bronchoscopy. After satisfactory mechanical ventilation, remove the larynx mask after the patient is awake. The complications of pharynx and larynx were observed and recorded. Results 32 cases of grade 3 and 4 in group D were more than 26 cases in group B. the difference was statistically significant (P 0.05). Positive pressure ventilation was successfully performed in 8 cases of grade 1 and 2. There were 2 cases of failure, 58 cases of success of positive pressure ventilation in grade 3 and 4 under microscope, and no case of failure. There was a significant correlation between fiberoptic bronchoscopy grade and success rate of laryngeal mask positive pressure ventilation (P 0.05). In group B, there were 5 cases of grade 1 and 2 and 1 case of grade 3 and 4 under fiberoptic bronchoscopy, and there were no grade 1 and grade 2 cases in group D, and there were 6 cases of grade 3 and grade 4 in group D. Conclusion the method of selecting laryngeal mask model according to the distance between the distal lingual tip of mandibular second permanent molar can increase the probability of optimal intersession between laryngeal mask and glottis after insertion, and thus improve the success rate of laryngeal mask positive pressure ventilation. It is feasible in clinical practice.
【作者单位】：复旦大学附属金山医院麻醉科;复旦大学附属上海市第五人民医院麻醉科;
【分类号】：R614.21

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