ProSeal喉罩用于危重患者经皮扩张气管切开术的临床观察

摘要

目的 观察ProSeal喉罩用于危重患者经皮扩张气管切开术的临床效果.方法 将56例行经皮扩张气管切开术的危重患者随机分成气管插管组(T组)和喉罩组(L组),各28例.T组患者先予气管插管控制呼吸,再行PDT手术,而L组患者置入喉罩后接呼吸机辅助呼吸,再行PDT手术.分别记录麻醉诱导前即刻(T0)、诱导后3 min(T1)、气管插管或喉罩成功置入后即刻(T2)、气管插管或喉罩置入成功后3 min(T3)、气管造口即刻(T4)、气管造口成功后拔除气管插管或喉罩即刻(T5)患者的心率(HR)、平均动脉压(MAP)及指脉搏氧饱和度(SpO2),并记录插管(罩)时两组患者一次成功例数、二次成功例数、失败例数、插管用时和PDT手术耗时.结果 与气管插管组比较,喉罩组患者行PDT手术中血流动力更平稳;T组一次和二次插管成功率分别为82.1%和10.7%,L组为85.7%和14.3%,T组和L组插管时间分别为(26±4)s、(23±5)s,PDT耗时分别为(10.7±1.1)min和(8.9±1.3)min.结论 ProSeal喉罩能满足危重患者PDT手术气道管理的要求,且循环稳定,操作时间短.%Objective To observe the effect of laryngeal mask on critical patients undergoing Pcrcutancous dilational tracheodtomy (PDT). Methods 556 patients who underwent PDT were randomly divided into two groups:laryngeal mask group (group L) and tracheal intubated group (group T). Before operation of PDT, laryngeal mask airway was inserted in group L, and tracheal tube was intubated in group T. The changes of HR, .MAP and SpO2 were recorded during the operation; meanwhile the last time of PDT was measured. Results Compared to that in group T,the hemodynamics was more stable in group L during the operation of PDT. One-time and second-time successful rate at intubation for T group were 82.1％ and 10.7％, respectively, while 85.7％ and 14.3％ for L group, respectively. The intubation time for both group were (26±4) s and (23±5) s, respectively. PDT consuming time were (10.7±l.1) min and (8.9±1.3) min, respectively. Conclusion Laryngeal mask airway of PreSeal can satisfy airway management during operation of PDT, which can make more stable hemodynamics and spare less time.