Ambu+Aura-i喉罩联合纤维支气管镜用于鼾症患者气管插管的临床观察

·12·中国实用医药2017年1月第12卷第2期　China Prac Med, Jan 2017, Vol. 12, No.2Ambu Aura-i 喉罩联合纤维支气管镜用于鼾症患者气管插管的临床观察

樊伟 王榆富 张新龙 王晋平

【摘要】 目的 观察Ambu Aura-i 喉罩联合纤维支气管镜(FOB) 引导气管插管在鼾症患者中应用的可行性。方法 40例符合条件的鼾症患者, 随机分为F 组(FOB 引导)和L 组(盲探), 各20例。麻醉诱导后置入喉罩, 经喉罩由FOB 引导插管或盲探插管。记录喉罩置入及气管插管的次数和时间, 以及麻醉诱导前基础值(T0)、麻醉透导后(T1)、置入喉罩后(T2)、插管即刻(T3)的收缩压(SBP)、舒张压(DBP)和心率(HR)；观察喉罩退出时是否带血迹并随访术后患者不良反应。结果 两组首次喉罩置入成功率比较差异无统计学意义(P>0.05)。F 组气管插管总成功率100%高于L 组75%, 差异具有统计学意义(P<0.05)。F 组首次插管成功时间及二次插管成功时间均短于L 组, 差异均具有统计学意义(P<0.05)。两组T3时点SBP、DBP 和HR 均较T1明显升高, 差异均具有统计学意义(P<0.05), 但与T0比较差异无统计学意义(P>0.05)。两组间各时点SBP、DBP 和HR 比较差异无统计学意义(P>0.05)。L 组拔出喉罩后带血6例, 术后咽痛5例；F 组拔出喉罩后带血3例, 术后咽痛1例。F 组不良反应发生情况少于L 组, 差异具有统计学意义(P<0.05)。结论 Ambu Aura-i 喉罩联合FOB 用于鼾症患者气管插管成功率高、效果好且不良反应少。

【关键词】 Ambu Aura-i 喉罩；纤维支气管镜；鼾症

DOI ：10.14163/http://ki.11-5547/r.2017.02.005

Clinical observation on Ambu Aura-i laryngeal mask combined with fiberoptic bronchoscope for tracheal intubation in snore symptom patients FAN Wei, WANG Yu-fu, ZHANG Xin-long, et al. Department of Anesthesiology, Shanxi Province Jinmei Group General Hospital, Jincheng 048006, China

【Abstract 】 Objective To observe feasibility of Ambu Aura-i laryngeal mask combined with fiberoptic bronchoscope (FOB) for tracheal intubation in snore symptom patients. Methods A total of 40 eligible patients with snore symptom were randomly divided into group F (FOB guiding) and group L (blind exploring), with 20 cases in each group. The laryngeal mask was placed after anesthesia induction, guiding by FOB for intubation or blind intubation by laryngeal mask. Record were made on times and duration in laryngeal mask placement and tracheal intubation, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) at base value (T0) before anesthesia induction, after anesthesia induction (T1), after laryngeal mask placement (T2), immediate intubation (T3). Whether there was blood or not when removal laryngeal mask was observed and follow-up reviewed postoperative adverse reactions in patients. Results There were no statistically significant difference in first successful intubation rate of laryngeal mask placement between two groups (P>0.05). Group F had higher total success rate in tracheal intubation as 100% than 75% in group L, and the difference had statistical significance (P<0.05). Group F had shorter first successful intubation time and second successful intubation time than those in the group L, and their differences had statistical significance (P<0.05). Both groups had higher SBP, DBP and HR at T3 point than T1 point, and the difference had statistical significance (P<0.05), but had no statistically significant difference compared with T0 point (P>0.05). Group L had 6 bloody cases after removal of laryngeal mask, 5 postopervative pharyngalgia cases, while 3 and 1 case in group F. Group F had less occurrence of adverse reactions than group L, and their difference had statistical significance (P<0.05). Conclusion Ambu Aura-i laryngeal mask combined with FOB shows high success rate, good curative effect and few adverse reactions for tracheal intubation in snore symptom patients.

【Key words 】 Ambu Aura-i laryngeal mask; Fiberoptic bronchoscope; Snore symptom

作者单位：048006　山西省晋煤集团总医院麻醉科Ambu Aura-i 喉罩是一款气管插管型喉罩, 在普通喉罩

通气功能上, 可进行盲探气管插管, 还可运用FOB 引导进行

气管插管, 一定程度上降低了困难气道的插管难度［1］。 阻塞

性睡眠呼吸暂停综合征(OSAS)即鼾症, 此类患者不同程度的

存在着咽腔及相关组织结构异常, 可被归类于困难气道［2］。本研究通过对鼾症患者全身麻醉诱导后运用Ambu Aura-i 喉罩联合FOB 进行气管插管和盲探插管两种方式对比研究, 为鼾症患者困难气道插管提供新思路, 现报告如下。1 资料与方法1. 1 一般资料　选择本院择期全身麻醉下行腭咽成形术鼾万方数据

·13·中国实用医药2017年1月第12卷第2期　China Prac Med, Jan 2017, Vol. 12, No.2

症患者40例(2016年1~10月病例), ASAⅠ~Ⅱ级, 年龄34~58岁, 体重77~98 kg。随机分为F组(FOB引导)和L组(盲探), 各20例。入选标准:所有患者至少具备1项困难气道插管标准(甲额距离<6 cm；张口度<3 cm且>1.5 cm以便能置入喉罩；Mallampati分级Ⅲ或Ⅳ级)。排除标准：张口度<1.5 cm、扁桃体Ⅲ度及以上肥大、有严重心肺功能障碍。两组患者的一般情况和麻醉前气道评估指标甲颏距离、张口度和 Mallampati分级比较差异均无统计学意义 (P>0.05), 具有可比性。见表1。

表1　两组患者一般情况和插管条件比较( x-±s, n)项目F组(n=20)L组(n=20)年龄(岁)45±6a43±5

体重(kg)81.4±7.9a78.5±7.1性别(男/女)19/1a20/0

甲颏距离(cm) 6.7±1.4a 6.6±1.7

张口度(cm) 4.4±1.2a …… 此处隐藏：6400字，全部文档内容请下载后查看。喜欢就下载吧 ……