文章摘要
双气道喉管用于中心气道狭窄气管支架置入术的效果
Effect of double airway larynx on stent implantation for central airway stenosis
  
DOI:10.12089/jca.2021.10.008
中文关键词: 双气道喉管  中心气道狭窄  支架置入
英文关键词: Double airway larynx  Central airway stenosis  Stent implantation
基金项目:河南省医学科技攻关计划项目(201303173)
作者单位E-mail
侯铁柱 450003,郑州大学人民医院麻醉与围术期医学科  
张加强 450003,郑州大学人民医院麻醉与围术期医学科 hnmzxh@163.com 
代彦文 450003,郑州大学人民医院麻醉与围术期医学科  
童明军 450003,郑州大学人民医院麻醉与围术期医学科  
代山 450003,郑州大学人民医院麻醉与围术期医学科  
吴敏 450003,郑州大学人民医院麻醉与围术期医学科  
刘胜群 450003,郑州大学人民医院麻醉与围术期医学科  
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中文摘要:
      
目的 评价双气道喉管用于中心气道狭窄气管支架置入术的效果。
方法 选择择期行中心气道狭窄气管支架置入术患者42例,男28例,女14例,年龄18~64岁,ASA Ⅱ或Ⅲ级。采用随机数字表法分为两组:双气道喉管组(D组)和普通喉罩组(C组),每组21例。麻醉诱导后,D组、C组分别置入双气道喉管和普通喉罩,行机械通气。记录麻醉诱导前(T1)、置入喉管/喉罩开始通气时(T2)、手术开始(T3)、支架置入时(T4)及术毕停止麻醉药后5 min(T5)的MAP、HR和SpO2。分别于支架置入前和置入后抽取动脉血样行血气分析,记录pH值、PaO2和PaCO2。记录手术时间和支架置入调整例数。记录气管黏膜损伤、术后声嘶和术后咽痛的发生情况。
结果 T1—T5时两组MAP、HR和SpO2差异无统计学意义。与C组比较,D组支架置入后pH值、PaO2明显升高,PaCO2明显降低,手术时间明显缩短,支架置入调整例数明显减少,气管黏膜损伤、术后声嘶和术后咽痛发生率明显降低(P<0.05)。
结论 双气道喉管用于中心气道狭窄气管支架置入术,可有效减少并发症的发生。
英文摘要:
      
Objective To evaluate the effect of double airway larynx on stent implantation for central airway stenosis.
Methods Forty-two patients scheduled for elective stent implantation for central airway stenosis, 28 males and 14 females, aged 18-64 years, ASA physical status Ⅱ or Ⅲ, were randomly divided into two groups (n = 21 each) using a random number table method: double airway larynx group (group D) and common larynx group (group C). After anesthesia induction, laryngeal mask or double airway larynx were placed, mechanical ventilation was performed, and tracheoscopy was used to locate or guide stent implantation. MAP, HR and SpO2 were recorded before anesthesia induction (T1), at the beginning of laryngeal mask / larynx ventilation (T2), at the beginning of surgery (T3), at the time of stent implantation (T4), and 5 minutes after anesthesia cessation (T5). Arterial blood samples were extracted before and after stent implantation for blood gas analysis, and pH, PaO2 and PaCO2 were recorded. Operation time and number of stent adjustment cases were recorded. The occurrence of tracheal mucosa injury, postoperative hoarseness and postoperative pharyngeal pain were recorded.
Results There was no significant difference between group D and group C in MAP, HR, SpO2 at T1-T5. Compared with group C, the pH value and PaO2 in group D were significantly increased immediately after stent implantation, PaCO2 was significantly decreased, the operation time was significantly shortened, the number of stent implantation adjustment cases was significantly reduced, and the incidence of trachea mucosal injury, postoperative hoarsing and postoperative sore throat were significantly decreased (P < 0.05).
Conclusion Double airway larynx is feasible for central airway stenosis tracheal stent implantation, which effectively reduces complications.
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