喉罩在宫腔镜手术患者气道管理中的应用#br#

［摘要］目的探讨喉罩在宫腔镜手术患者气道管理中的应用效果。方法选取全身麻醉下妇科宫腔镜手术患者150例，随机分为3组各50例。T组采用气管插管建立安全气道，P组采用ProSeal喉罩，S组采用Supreme喉罩。观察3组气管插管或喉罩置入的次数、成功率以及术中情况、生命体征、并发症发生情况。结果P组和S组1次置入成功率高于T组（P＜0.05）。S组置入时间短于T组，P组和S组拔管时间短于T组，气道密封压均高于T组（P＜0.05）。P组和S组喉罩置入成功率、置入时间、拔管时间、气道密封压差异均无统计学意义（P＞0.05）。3组麻醉时间、苏醒时间差异均无统计学意义（P＞0.05）。3组各时点平均动脉压（mean artery pressure，MAP）、心率（heart rate，HR）、血氧饱和度（pulse oxygen saturation,SpO2）水平均有波动，其时点间、组间·时点间交互作用差异均有统计学意义（P＜0.05），而3组间MAP、HR、SpO2差异均无统计学意义（P＞0.05）。P组和S组咽喉疼痛、吞咽困难发生率均低于T组（P＜0.05）。3组呛咳、喉痉挛、胃胀气、下颌疼痛发生率差异均无统计学意义（P＞0.05）。结论全身麻醉下宫腔镜手术采用喉罩建立安全气道，相比气管插管，操作简单、易于置入，通气效果和气道密封性好，对患者术中的血流动力学无影响，拔除后并发症较少。ProSeal喉罩和Supreme喉罩均应用良好，可安全用于宫腔镜手术患者的气道管理。

Application of laryngeal mask in airway management of patients undergoing hysteroscopic surgery

［Abstract］Objective〖HTSS〗To explore the application effects of laryngeal mask in airway management of patients undergoing hysteroscopic surgery. Methods〖HTSS〗A total of 150 patients who underwent gynecological hysteroscopic surgery under general anesthesia were selected and randomly divided into three groups, with 50 cases in each group. T group was given tracheal intubation to establish a safe airway, and P group was given ProSeal laryngeal mask, and S group was given Supreme laryngeal mask. The frequencies and success rate of tracheal intubation or laryngeal mask placement, intraoperative conditions, vital signs and complications were observed among three groups. Results〖HTSS〗The success rate of one-time placement in P group and S group was higher than that in T group(P＜0.05). The placement time in S group was smaller than that in T group, and the extubation time in P group and S group was smaller than that in T group, and the airway sealing pressure was higher than that in T group(P＜0.05). There were no significant differences in the success rate, placement time, extubation time and airway sealing pressure of laryngeal mask placement between P group and S group(P＞0.05). There were no significant differences in anesthesia time and recovery time among three groups(P＞0.05). The mean artery pressure(MAP), heart rate(HR) and pulse oxygen saturation(SpO2) in the three groups were fluctuating at each time point, and there were statistically significant differences in the time-point effects and interactions of time-point and between-groups(P＜0.05), and there were no significant differences in the MAP, HR and SpO2 among the three groups at each time point(P＞0.05). The incidence rates of postoperative sore throat and dysphagia in P group and S group were lower than those in T group(P＜0.05). There were no significant differences in the incidence rates of bucking, laryngospasm, gaseous distention and jaw pain among the three groups(P＞0.05). Conclusion〖HTSS〗Compared with tracheal intubation, hysteroscopic surgery under general anesthesia for laryngeal mask to establish a safe airway is easy to operate and easy to place, and it has better ventilation effects and airway sealing, and has no effects on hemodynamics during surgery and fewer complications after extubation. ProSeal laryngeal mask and Supreme laryngeal mask are well-applied for safe airway management in patients undergoing hysteroscopic surgery.