SaCo可视喉罩气道导管在腹腔镜胆囊切除术中患者气道管理的应用

摘要/Abstract

摘要： 目的探讨与分析SaCo可视喉罩气道导管在腹腔镜胆囊切除术中患者气道管理的应用价值。方法选择2022年12月—2023年7月在安康市中医医院进行择期腹腔镜胆囊切除术的 138 例患者作为研究对象,根据1:1随机数表法把138例患者分为SaCo组46例、WORK组46例、对照组46例。SaCo组使用SaCo可视喉罩辅助气道管理,WORK组使用WORK喉罩导管辅助气道管理,对照组使用气管插管辅助气道管理。测定与记录患者的生命体征、围手术期指标、并发症发生情况与疼痛评分变化情况。结果所有患者都一次性置管成功,SaCo组、WORK组、对照组在T1时间点、T2时间点、T3时间点、T4时间点、T5时间点的中心动脉压、心率在组内与组间比较,差异无统计学意义（P>0.05）。SaCo组的手术时间、麻醉时间、术后拔管时间、术后住院时间、术后进普食时间与WORK组与对照组相比明显减少,差异有统计学意义（P<0.05）。SaCo组术后拔管期间的咽喉部出血、声音嘶哑、呛咳、咽喉疼痛、支气管痉挛等并发症发生率明显低于WORK组与对照组,差异有统计学意义（P<0.05）。SaCo组术后1 d、术后3 d、术后7 d、术后14 d的疼痛VAS评分与WORK组、对照组相比明显降低,差异有统计学意义（P<0.05）。结论 SaCo可视喉罩气道导管在腹腔镜胆囊切除术中患者气道管理的应用并不会影响患者的生命体征,也可降低患者的并发症发生率,减少对患者的创伤,促进患者康复,缓解患者的疼痛状况。

关键词: SaCo可视喉罩气道导管, 腹腔镜胆囊切除, 气道管理, 疼痛, 并发症发生情况, 生命体征

Abstract: Objective To explore and analysis the application values of SaCo visible laryngeal mask airway catheter in patient airway management during laparoscopic cholecystectomy. Methods 92 cases of patients who underwent elective laparoscopic cholecystectomy Ankang Hospital of Traditional Chinese Medicine from December 2022 to June 2023 were selected as the study subjects. Accorded to a 1:1 random number table method, 138 patients were divided into the SaCo group of 46 cases, the WORK group of 46cases, the control group of 46 cases. The SaCo group were used SaCo visual laryngeal mask to assist in airway management, while the WORK group were used WORK catheters to assist in airway management, The control group were used Tracheal intubation to assist airway management. The patient's vital signs, perioperative indicators, complications, and pain scores were measured and recorded. Results All patients were successfully intubated at once, and there were no significant difference in central arterial pressure and heart rate compared among the SaCo group, the WORK group, the control group at T1, T2, T3, T4, and T5 time points (P>0.05). The surgical time, anesthesia time, postoperative extubation time, postoperative hospitalization time, and postoperative general feeding time in the SaCo group were significantly reduced compared to the WORK group, the control group (P<0.05). The incidence rates of complications such as throat bleeding, Hoarse voice, choking, sore throat, and Bronchospasm during extubation after operation in the SaCo group were 4.35%, and 19.57%, 21.74% in the WORK group and the control group. Compared with the WORK group and the control group, the incidence of complications in the SaCo group were significantly lower (P<0.05). The pain VAS scores of the SaCo group were significantly reduced compared to the control group, the WORK group on the 1st, 3rd, 7th, and 14th postoperative days (P<0.05). Conclusion The application of SaCo visual laryngeal mask airway catheter in patient airway management during laparoscopic cholecystectomy does not affect the patient's vital signs, can also reduce the incidence of complications, reduce trauma to patients, promote patient recovery, and alleviate patient pain.

Key words: SaCo visible laryngeal mask airway catheter, laparoscopic cholecystectomy, airway management, pain, complications, vital signs

中图分类号:

R614

贺宏智, 谢力, 欧锋, 韩飞, 赵启彬, 廖伟芋, 井立说, 刘普可, 汪霄. SaCo可视喉罩气道导管在腹腔镜胆囊切除术中患者气道管理的应用[J]. 中华养生保健, 2024, 42(8): 12-16.

HE Hong-zhi, XIE Li, OU Feng, HAN Fei, ZHAO Qi-bin, LIAO Wei-yu, JING Li-shuo, LIU Pu-ke, WANG Xiao. Application of SaCo Visible Laryngeal Mask Airway Catheter in Patient Airway Management During Laparoscopic Cholecystectomy[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(8): 12-16.

参考文献

[1] 邢秀花,符先先,倪文宗,等.老年髋部手术应用不同无菌一次性喉罩全麻的比较及对术后镇痛的影响[J].中国临床保健杂志,2023,26(2):206-209.
[2] 廖志品,江辉,田学愎,等.回顾性分析喉罩与气管插管全麻在气管狭窄手术中的临床应用[J].麻醉安全与质控,2021,5(5):253-256.
[3] 王栋,陈文栋,谭莹.基于可视化技术的困难气道处理模拟训练在麻醉学教学中的应用[J].卫生职业教育,2021,39(14):80-81.
[4] HUSSAIN D, KUNDAL R, KUMAR A, et al.An Analysis of the Comparative Efficacy Between a Third-Generation and a Second-Generation Supraglottic Airway Device in Patients Undergoing Laparoscopic Cholecystectomy[J]. Cureus,2022,14(2):e22592.
[5] KUMAR B, GUPTA B, THAKUR A, et al.Comparative evaluation of airway dynamics in patients undergoing laparoscopic cholecystectomy under general anaesthesia with controlled ventilation using ProSeal laryngeal mask airway, I-Gel™ and Baska mask[J]. Indian J Anaesth,2022,66(12):842-848.
[6] 吴言悟,李秀珍,王燊妮.瑞芬太尼联合丙泊酚对喉罩通气急救患者的麻醉效果[J].临床合理用药,2023,16(6):78-81.
[7] 王桂娟,麻晓晨,杜胜杰,等.可视喉罩联合支气管封堵器在胸腔镜肺叶部分切除术中的应用[J].腹腔镜外科杂志,2022,27(12):938-943.
[8] 郅娟,邓晓明,杨冬,等.可视喉罩置入对小耳畸形患儿咽喉部黏膜即刻损伤的临床观察[J].北京医学,2022,44(9):850-853.
[9] 阮孝国,郭高峰,孙铭阳,等.可视食管引流型、免充气与Supreme喉罩用于全麻剖宫产术患者气道管理效果的比较[J].广东医学,2022,43(8):988-993.
[10] 王嘉锋,赵珍珍,包睿,等.可视喉罩联合支气管封堵器降低胸腔镜肺切除术后咽喉疼痛发生率[J].上海医学,2022,45(3):175-178.
[11] 解凤磊,王春侠,闫声明,等.SaCo可视喉罩在侧卧折刀位腹腔镜手术患者的临床效果观察[J].淮海医药,2022,40(2):165-167.
[12] 郅娟,邓晓明,杨冬,等.SaCoVLM可视喉罩与Air-Q插管型喉罩用于儿童气管插管的比较研究[J].北京医学,2022,44(2):141-144.
[13] 白鹏,怀伟,夏天,等.气管插管和喉罩在手术室与滑雪场雪道建立人工气道时间的比较[J].北京大学学报(医学版),2022,54(1):166-169.
[14] 张敏,高晓军,高中权,等.SaCo可视喉罩和Supreme喉罩用于腹腔镜手术的比较[J].临床麻醉学杂志,2021,37(12):1271-1274.
[15] 张国生. 可塑可视型喉镜用于喉罩定位对病人血流动力学及咽喉不适的影响[J].现代诊断与治疗,2019,30(20):3579-3580.
[16] 严峰,屠秀菊,李军,等.纤维支气管镜联合超声定位喉罩在老年全身麻醉患者气道管理中的应用[J].中国内镜杂志,2018,24(3):11-15.
[17] 阮义峰,陆军,曾琼,等.可视喉镜在神经外科术中唤醒气道管理的应用价值[J].临床神经外科杂志,2017,14(6):450-452.
[18] 郅娟,杨冬,邓晓明,等.SaCo可视喉罩引导气管插管在小耳畸形患儿中的应用[J].临床麻醉学杂志,2021,37(11):1195-1197.
[19] 朱彤彤,王朝霞,齐悦.可视化技术定位喉罩插管对老年全麻病人血流动力学参数的影响[J].实用老年医学,2021,35(10):1058-1062.
[20] FAN H, LI L, ZHU L, et al.Comparison of the third-generation streamlined liner of the pharynx airway (SLIPA-3G) with the laryngeal mask airway supreme for laparoscopic cholecystectomy: a randomized prospective study[J]. BMC Anesthesiol,2022,22(1):97-101.