经典喉罩全麻在老龄和年轻患者中的临床应用比较分析

摘要

Objective To compare the clinical efficacy of the classic laryngeal mask airway between the elderly and young adult patients.Methods 54 elderly patients (aged ≥65 years)and 54 young adult patients (aged <65 years) scheduled for surgery using the laryngeal mask airway for general anesthesia were chosen in this study.Manipulation required during insertion,success rate of first attempt,insertion time,oropharyngeal leak pressure,gastric insufflation and complications 24 h after surgery were assessed and recorded.Results The insertion success rate on the first at-tempt in young group was significantly higher than that in elderly group (96% vs 85%,P =0.03),and the used inser-tion time was significantly lower than that in elderly group (22.2±4.6 vs 28.6±6.7 seconds,P =0.01).In 2 patients in elderly group,the proper placement of laryngeal mask airway failed despite a second attempt,and then it changed to endotracheal intubation.After the proper placement of the classic laryngeal mask airway,there was no notable differ-ence in the peak airway pressure,oropharyngeal leak pressure,incidence of gastric insufflation and desaturation,and Bri-macombe score between two groups(P >0.05).Moreover,the difference in the complication 24 h postoperatively be-tween two groups was not significant(P >0.05).Conclusion The clinical efficacy of classic laryngeal mask airway in young adult patients was higher than that in the elderly patients.%目的 分析并比较经典喉罩全麻在老龄和年轻患者中的临床应用.方法 选取2014年2月至2016年7月于我院拟行经典喉罩全麻手术的老龄(年龄≥65岁)和年轻(年龄<65岁)成年患者各54例为本研究试验对象.评估并记录喉罩置入过程中的操作要求、首次成功率、置入时间、口咽漏气压、胃胀气及术后24 h并发症情况.结果 年轻组首次置入成功率显著高于老年组(96%vs 85%,P=0.03),且置入时间显著低于老年组(22.2±4.6 vs 28.6±6.7秒,P=0.01).老年组有2例患者置入失败改为气管插管.喉罩置入后,两组患者在气道压力峰值、漏气压、胃胀气和低血氧症发病率及Brimacombe评分方面均无显著差异(P>0.05),且两组在术后24 h的不良反应的差异也无显著统计学意义(P>0.05).结论 经典喉罩全麻在年轻成年患者中的临床有效性显著高于老年患者.