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| SaCo可视喉罩联合支气管封堵器在微创胸腔镜手术患者中的应用 |
| Effect of SaCo visual laryngeal mask airway combined with bronchial blocker on the minimally invasive thoracoscopic patients |
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| DOI：10.12089/jca.2021.05.012 |
| 中文关键词: SaCo可视喉罩 支气管封堵器 胸腔镜手术 气管导管 恢复质量 |
| 英文关键词: SaCo visual laryngeal mask airway Bronchial blocker Thoracoscope Endotracheal tube Quality of recovery |
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| 中文摘要: |
目的 探讨SaCo可视喉罩联合支气管封堵器在微创胸腔镜手术患者中的应用。
方法 选择2019年2月至2020年4月择期行微创胸腔镜手术患者77例，男52例，女25例，年龄18~80岁，BMI 19~24 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者分为两组：喉罩组（LM组，n=39）和气管导管组（ET组，n=38）。LM组使用SaCo可视喉罩联合支气管封堵器，ET组使用气管导管联合支气管封堵器。记录插管（或喉罩）后5 min（T1）、单肺通气5 min（T2）、单肺通气1 h（T3）和双肺通气5 min（T4）时气道峰压（Ppeak）、气道平台压（Pplat）和SpO2。记录术前1 d和术后1 d恢复质量评分量表（QoR-15）评分。记录术中肺萎陷评分、Aldrete苏醒评分、拔管时间、放置或拔除人工气道后应用血管活性药物例数、苏醒期呛咳例数、术后咽喉疼痛例数。
结果 与ET组比较，LM组T1—T4时Ppeak和Pplat明显降低（P<0.05），术后1 d QoR-15评分明显升高（P<0.05），拔管时间明显缩短（P<0.05），放置或拔除喉罩后使用血管活性药物例数明显减少（P<0.05），苏醒期呛咳、术后咽喉疼痛发生率明显降低（P<0.05）。
结论 SaCo可视喉罩联合支气管封堵器应用于微创胸腔镜手术时术中通气效果好，术毕苏醒速度快，术后不良反应发生率低，恢复质量高，可为临床应用提供参考。 |
| 英文摘要: |
Objective To investigate the effect of SaCo laryngeal mask combined with bronchial blocker in patients undergoing minimally invasive thoracoscopic surgery.
Methods Seventy-seven patients underwent elective minimally invasive thoracoscopic surgery from February 2019 to April 2020, 52 males and 25 females, aged 18-80 years, BMI 19-24 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups: laryngeal mask group (group LM, n = 39) and endotracheal tube group (group ET, n = 38). Group LM was Saco visual laryngeal mask combined with bronchial occluder and group ET with endotracheal tube combined with bronchial occluder . The airway peak pressure (Ppeak), airway plateau pressure (Pplat) and SpO2 at 5 minutes after intubation (or laryngeal mask) (T1), 5 minutes after one-lung ventilation (T2),1 hour after one-lung ventilation (T3) and 5 minutes after two-lung ventilation (T4) were recorded. The recovery quality scale (QoR-15) scores were recorded at 1 day before operation and 1 day after operation, the intraoperative lung collapse score, the Aldrete recovery score, the time of extubation, the number of using vasoactive drugs after placing or removing artificial airway, the incidence of cough during the recovery period and the incidence of postoperative throat pain were recorded.
Results Compared with group ET, Ppeak and Pplat in group LM were significantly lower at T1-T4 (P < 0.05). The QoR-15 scale scores 1 day after operation and Aldrete recovery scores in group LM were higher (P < 0.05). The time of extubation in group LM was significantly shorter (P < 0.05), the number of using vasoactive drugs after placing or removing artificial airway, the incidence of cough during the recovery period and postoperative throat pain in group LM decreased significantly (P < 0.05).
Conclusion The combination of SaCo laryngeal mask and bronchial blocker in minimally invasive thoracoscopic surgery can achieve good intraoperative ventilation effect, and get better quality of recovery. |
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