改良喉罩控制通气在无痛纤维支气管镜检查中的应用

目的 观察改良喉罩在无痛纤维支气管镜检查、活检、小剂量灌洗等治疗应用中的效果.方法 拟行无痛纤维支气管镜检查的患者25例,ASAⅠ~Ⅲ级,年龄21~80岁,在静脉快速诱导下插入喉罩,连接三通导管,一端接麻醉机控制通气,从另一端带有硅胶密封口处置入纤维支气管镜进行检查、活检和灌洗等操作.术中监测收缩压（SBP）,舒张压（DBP）,心率（HR）,脉搏氧饱和度（SpO2）,潮气量（VT）,气道峰压（Ppeak）,呼气末二氧化碳分压（PETCO2）.结果 所有患者都顺利完成手术,术中收缩压、舒张压和心率等循环指标平稳,SpO2维持良好,气道峰压和PETCO2均无明显改变,呼吸道通畅,无缺氧和二氧化碳蓄积.结论 改良喉罩控制通气在无痛纤维支气管镜检查、治疗中的呼吸管理安全、可靠、效果满意.

Application of controlled ventilation with improved laryngeal mask airway in fiberoptic bronchoscopy

Objective To observe the clinical effect of controlled ventilation with improved laryngeal mask airway in fiberoptic bronchos-copy. Methods Twenty five ASA I or In grade patients , aged 21-80 years, undergoing fiberoptic bronchoscopy, admitted for tracheal intubation with improved laryngeal mask airway ventilation under general anesthesia, were studied. The patients were mechanically venti-lated during operation. SBP, DBP, HR, SpO2, the tidal volume （TV）, peak inspiratory pressure（ Ppeak ）and partial pressure of carbon diox-ide in end expiratory gas（PET CO2 ） were recorded. Results All the operations were successful. Satisfactory effects were observed in 25 cases under study. No side effect and complications were observed in any cases. Conclusions Controlled ventilation with improved la-ryngeal mask airway is a safe and effective alterative to fiberoptic bronchoscopy.