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压舌板辅助法在可弯曲喉罩置入中的应用

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压舌板辅助法在可弯曲喉罩置入中的应用
熊婷婷,王莉莉,金玲艳*,姚毅真,周建文
复旦大学附属上海市第五人民医院麻醉科,上海200240
摘要:
目的:探讨压舌板辅助手法放置可弯曲喉罩的可行性。方法:选择拟于可弯曲喉罩全麻下行择期手术的患者64例,性别不限,年龄18~80岁,ASAⅠ~Ⅲ级。采用随机信封法将其分为标准手指引导组和压舌板辅助组,每组32例。分别记录两组喉罩置入时间、口咽部泄露压、纤维支气管镜视野评分和首次置管成功率及术后24h内咽痛的发生情况。结果:最终62例患者的资料纳入统计分析,标准手指引导组31例、压舌板辅助组31例。压舌板辅助组患者纤维支气管镜视野评分高于标准手指引导组(Z=-4.241,P<0.001);压舌板辅助组口咽部泄露压高于标准手指引导组(t=-4.474,P<0.001)。与标准手指引导组患者相比,压舌板辅助组置管时间较长(t=-15.171,P<0.001)。压舌板辅助组首次置管成功率(100%)与标准手指引导组(93.55%)差异无统计学意义。两组患者术后24h内均未发生咽痛情况。结论:压舌板辅助法置入可弯曲喉罩可明显提高喉罩对位准确率,提高喉罩口咽部密闭性,且不增加术后咽痛的发生率,值得在临床工作中推广应用。
关键词:   可弯曲喉罩   标准手指引导法   压舌板   纤维支气管镜   泄露压
DOI:10.12025/j.issn.1008-6358.2019.20180901
分类号:R 614.2
基金项目:复旦大学附属上海市第五人民医院院级医学重点专科项目(2017WYZDZK10)

Application of the spatula-assisted technique in placing a flexible laryngeal mask airway


Abstract:
Objective:To explore the feasibility of placing a flexible laryngeal mask airway (fLMA) with the spatula-assisted technique. Methods:A total of 64 patients scheduled for elective surgery under general anesthesia with fLMA, aged 18-80 years old, with an ASA grade of Ⅰ-Ⅲwere selected. The patients were randomly divided into standard finger-guided group and spatula-assisted group using random envelope method, with 32 cases in each group. The insertion time of fLMA and oropharyngeal leak pressure were measured, and the fiberoptic view score, first insertion success rate, and sore throat rate were recorded in two groups. Results:Sixty-two patients were available for the final statistical analysis, with 31 cases in each group. Fiberoptic view score and oropharygeal leakage pressure were significantly higher in the spatula-assisted group than those in the standard finger-guided group (Z=-4.241,P<0.001; t=-4.474,P<0.001). The insertion time was significantly longer in the spatula-assisted group than that in the standard finger-guided group (t=-15.171,P<0.001). There was no significant difference in the first insertion success rate between the two groups (100% vs 93.55%). There was no sore throat within 24 hours in both groups. Conclusions:The spatula-assisted technique can significantly improve the efficiency of fLMA, and it can be further applied in clinical work.
Key words:   flexible laryngeal mask airway   standard finger-guided   spatula   fiberoptic view   leakage pressure


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