摘要
目的 探讨改良喉罩通气管理模式在支气管内超声引导针吸活检术（EBUS-TBNA）中的应用.方法 2012年9月至2013年5月择期实施EBUS-TBNA的男性患者42例.通过改良喉罩通气管理模式进行静吸复合全麻,观察术中气道压力、SpO2、PETCO2、PaCO2,呛咳、体动、手术操作连续/暂停,患者、胸外科医师、麻醉医师对该方法的满意度.结果 改良喉罩通气下控制呼吸与支气管内镜操作互不干涉,患者通气良好.气道压力控制在25 cmH2O以内,PETCO2 35～50 mmHg,SpO2 98～100 mmHg,手术前后2次血气分析结果为PaCO2 30～49 mmHg、Lac 0.1～2.1 mmol、HCO-3 21～26 mmHg、BE -2～3 mmHg.未发生呛咳、体动、气道痉挛、气胸及明显的气道内活动性出血等并发症.术后5 min内拔除喉罩,患者很满意度达100%,术后感觉舒适、无痛苦记忆,8例术后有咽喉不适感、次日改善.胸外科医师很满意度达100%,操作过程连续,无后顾之忧.麻醉很满意达100%,方法安全、有效,可控性强,操作简便.结论 改良喉罩通气全麻能取得满意的麻醉效果,控制呼吸与支气管内镜操作互不干涉,安全舒适.
Objective To observe the clinical application of the modified laryngeal mask airway for endobronchial ultrasound-guided transbronchial needle aspiration biopsy.Method By the induction of the general anesthesia, 42 patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration biopsy between september 2012 and may 2013 were managed with the modified laryngeal mask airway.The group consisted of 42 male patients aged 56 years to 67 years, with a median age of 61.Result No patient experienced any complications related to the operation, such as bucking,body movement,tracheospasm,pneumothorax and heavy bleeding.Controlled ventilation and bronchial endoscopy were non-interference in each other.And all patients had good ventilation.The satisfaction of thoracic surgery physicians, patients and anesthesiologists were also 100%.Conclusion For patients presenting with EBUS-TBNA under general anesthesia with the modified laryngeal mask airway is a safe and reliable inspection method.This method can be used for routine examination.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第9期651-654,共4页
National Medical Journal of China
基金
福建中医药大学附属人民医院临床技术创新基金重点课题（CXZD1301）
