| 摘要: |
| ［摘要］ 目的 通过比较两组病人分别置入喉罩和气管内插管的成功率和血流动力学变化，凸显食管引流型喉罩（PLMA）在颈椎骨折手术麻醉中的优越性。方法 将60例ASAⅠ～Ⅲ级颈椎骨折需行手术治疗的病人随机分为两组：食管引流型喉罩组（A组）和盲插气管插管组（B组）。分别按常规麻醉诱导后置入气管导管或食管引流型喉罩（下统称麻醉构件）。记录两组患者诱导前、诱导后、置构件后1 min、3 min、拔出构件前及后5 min的SBP、DBP和HR值，还有置入构件所需的时间、成功率及并发症等。结果 成功置入构件后1 min和3 min的BP及拔出构件前后的BP、HR组间比较差异均有统计学意义（P<0.05），B组高于A组；而插置构件所用的时间和低氧血症、呛咳、支气管痉挛及出血血肿等麻醉并发症B组亦明显高于A组。结论 麻醉采用PLMA是一种操作简单快捷、安全舒适、术后呼吸道并发症少的呼吸支持方法，对颈椎骨折等插管困难病人尤其适用。 |
| 关键词: 食管引流型喉罩 颈椎骨折 麻醉 |
| DOI：10.3969/j.issn.1674-3806.2011.07.14 |
| 分类号:R 683 |
| 基金项目: |
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| Proseal laryngeal mask airway in the cervical spine fracture surgery |
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TANG Xiao-qi, HUANG Yan-hua
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Department of Anesthesiology,Affiliated Hospital of Xiangnan Medical College,Hunan 423000,China
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| Abstract: |
| ［Abstract］ Objective To highlight the advantages of proseal laryngeal mask airway (PLMA) in the anesthesia for cervical spine fracture surgery by comparing the success rates and hemodynamic changes between groups of patients inserted with laryngeal mask and endotracheal intubation respectively.Methods Sixty ASA status I-Ⅲ patients with cervical spine fracture requiring surgery were randomly divided into two groups: PLMA group (Group A) and blind endotracheal intubation group (Group B). After regular anesthesia induction, tracheal catheter and PLMA (hereinafter collectively called anesthesia components) were placed respectively. SBP, DBP and HR value before and after induction, at 1 min and 3 min after placing components, 5 min before and after removing components were recorded as well as the time required for placing the components, success rates and complications.Results There were significant differences in BP at 1 min and 3 min after successfully placing the components, and in BP and HR before and after removing the components for between groups (P<0.05); The values of Group B were higher than those of Group A; as for the time required for placing the components and anesthesia complications such as hypoxemia, irritating cough, bronchospasm, hemorrhage and hematoma, Group B was also significantly higher than Group A.Conclusion Adopting proseal laryngeal mask airway (PLMA) in anesthesia were a breath supporting method with easy operation, safety and rapidness, few postoperative respiratory complications, which is especially applicable for patients who are difficult for intubation because of cervical spine fracture etc. |
| Key words: Proseal laryngeal mask airway Cervical spine fracture Anesthesia |
