喉罩置入与气管插管在困难气道中应用的临床观察

目的比较喉罩置入和直接气管插管在困难气道中应用的优缺点。方法将美国麻醉医师协会(ASA)身体状况分级为Ⅱ～Ⅲ级、困难气道Mallanpatti分级Ⅲ级或以上,拟行全身吸入麻醉下行择期普外科手术患者60例,随机分为A组和B组,每组各30例。常规麻醉诱导后,A组采用喉罩置入,而B组使用气管导管。观察并记录两组患者喉罩与气管导管置入过程中心率、血压的变化,首次置入成功率以及术后拔出喉罩或气管导管后患者有无发生恶心、呕吐和咽部刺激症状。结果喉罩组在心率及血压变化、首次置入成功率、术后恶心、呕吐和咽部刺激症状等方面均优于导管组(P<0.05)。结论在困难气道中采用喉罩置入与气管插管相比,喉罩置入具有成功率高、血流动力学稳定、术后咽痛发生率小等优点,该方法简便、安全、有效和副作用少,值得临床推广应用。

A comparative study of laryngeal mask airway and endotracheal intubation in difficult airway patients with general anesthesia

Objective To observe the safety and efficacy of laryngeal mask airway and endotracheal intubation in difficult airway patients with general anesthesia.Methods 60 patients with ASAⅡ~Ⅲ,Mallanpatti scale Ⅲor above,scheduled for for elective common surgery under general anesthesia were randomized into 2 groups:laryngeal mask group(group A,n=30) and endotracheal intubation group(group B,n=30).After the routine anesthesia induction,laryngeal mask and endotracheal intubation were performed.Hemodynamic index,successful intubation ratio at one attempt and side effects of nausea,vomiting and pharygeagl stimulation were compared in two groups.Results The differences in blood pressure,the first successful intubation ratio,side effects of nausea,vomiting and pharygeagl stimulation between the two groups indicated that those of group A were much better than those in group B(P<0.05).Conclusion Laryngeal mask could maintain more stable hemodynamic index,obviously improve the successful intubation radio at one attempt and decrease side effects of nausea,vomiting and pharygeagl stimulation.