全麻机械通气SLIPA喉罩漏气相关因素分析

目的:筛选全麻机械通气使用SLIPA喉罩时发生漏气的相关因素。方法:选取短小全麻手术260例,记录患者性别、年龄、体质量指数、Mallampati分级、颈围、甲颏距、下颌骨水平长度、张口度以及牙齿情况。根据甲状软骨宽度选取合适型号的喉罩。操作者根据临床经验和潮气量监测判断喉罩是否漏气。采用卡方检验比较喉罩漏气和未漏气两组患者间各项指标的差异。结果:260例患者成功置入SLIPA喉罩,其中17例出现喉罩漏气。与喉罩未漏气患者相比,喉罩漏气患者短颏甲距(35%vs.5%)和无牙(29%vs.3%)的发生率更高(P<0.05)。结论:SLIPA喉罩可成功用于全麻机械通气患者,而颏甲距离短小或无牙的患者使用该类型喉罩存在漏气风险。

Factors associated with gas leakage in use of streamlined liner of the pharynx airway with la-ryngeal mask airway under general anesthesia

Objective：To verify the factors associated with gas leakage in applying of streamlined liner of the pharyngeal airway （ SLIPA） with classic la-ryngeal mask airway （LMA） to mechanically ventilated patients in general anesthesia.Methods：260 patients undergone minor surgery with general anes-thesia were included and recorded regarding the gender, ages, body mass index, Mallampati classification, neck circumference, thyromental distance （TMD）,mandibular length,width of mouth opening and status of teeth before anesthesia.Selection of the LMA size was complied to the width of thyroid cartilage of patients,and determination of LMA leakage was based on the operator′s experience and tidal volume monitoring.χ2 test was used to analyze the difference concerning the parameters described previously between the leakage group and the non-leakage group.Results：SLIPA LMAs were successfully applied in 254 patients,whereas LMA leakage was found in 17 cases.Higher incidence of the gas leakage was seen patients with shorter TMD （35% vs. 5%） and without teeth （29% vs.3% ）when the two groups were compared （P〈0.05）.Conclusion：SLIPA LMA can be safely used in mechanically ventilated patients under general anesthesia,yet higher incidences of gas leakage may be involved in those with short TMD or without teeth.