摘要
目的比较Air-Q和Ambu Aura-i气管插管型喉罩联合纤维支气管镜(FOB)用于耳畸形儿童气管插管的安全性和有效性。方法 120例全麻下行外耳再造手术患儿,根据体重随机分为Air-Q喉罩组(Air-Q组)和Ambu Aura-i喉罩组(Aura-i组),喉罩置入到位后,经Air-Q和Ambu Aura-i插管型喉罩联合FOB实施气管插管。记录喉罩置入、喉罩退出及FOB引导气管插管时间及次数;测量喉罩的套囊压、密封压;观察记录FOB在喉罩开口处的声门暴露分级、喉罩和气管插管操作过程对循环系统的影响以及术后并发症的发生情况。结果 120例患儿全部完成喉罩置入、气管插管和喉罩退出,Air-Q组和Aura-i组的喉罩置入时间、气管插管时间和喉罩退出时间分别为(14.1±7.2)s和(10.8±5.2)s(P<0.05)、(39.8±9.5)s和(24.1±8.2)s(P<0.05)、(18.2±5.1)s和(14.7±3.7)s(P<0.05);Air-Q组和Aura-i组在喉罩开口处FOB观察的声门暴露分级相近,声门直视率分别为80.0%和86.7%;Air-Q组和Aura-i组的平均漏气压分别为(20.5±4.8)cm H_2O和(22.2±5.0)cm H_2O(P<0.05),平均套囊压分别为(22.9±11.5)cm H_2O和(33.9±15.9)cm H_2O(P<0.05)。两种插管方式插管对血流动力学影响较小,术后2 h Air-Q组和Aura-i组分别有4例和3例发生咽痛,并发症较低。结论 Air-Q和Ambu Aura-i插管型喉罩联合FOB用于耳畸形儿童气管插管均有操作简单、插管成功率高、术后并发症少等优点,其中Ambu Aura-i插管型喉罩的优点更为突出。
Objective To compare the Ambu Aura-i with the Air-Q intubating laryngeal airway for fiberoptic-guided tracheal intubation in ear deformity children. Methods Totally 120 children who were scheduled for elective auricular reconstruction surgery requiring general anaesthesia with tracheal intubation were enrolled in this prospective study. They were randomized to receive either the Ambu Aura-i（ Aura-i group） or Air-Q（ Air-Qgroup）. The time for successful tracheal intubation was assessed. The attempts for successful device insertion,leak pressures,cuff pressures,fiberoptic grade of laryngeal view,time for removal of the device after endotracheal intubation,and complications were recorded. Results Device placement,endotracheal intubation,and removal after endotracheal intubation were successful in all patients. The Air-Q group required longer time than the Aurai group in device placement [（14. 1 ± 7. 2） s vs.（10. 8 ± 5. 2） s,P〈0.05],successful endotracheal intubation [（39. 8 ± 9. 5） s vs.（24. 1 ± 8. 2） s,P〈0.05],and device removal [（18. 2 ± 5. 1） s vs.（14. 7 ± 3. 7）s,P〈0.05]. There were no differences in fiberoptic grade of view between these devices,and the percentage of glottis seen was 80. 0%（ Air-Q group） vs. 86. 7%（ Aura-i group）. The leak pressure was（ 20. 5 ± 4. 8）cmH 2O in the Air-Q group and（22. 2 ± 5. 0） cmH 2O in the Aura-i group（ P〈0.05）,and the cuff pressure was（22. 9 ± 11. 5） cmH 2O in the Air-Q group and（33. 9 ± 15. 9） cmH 2O in the Aura-i group（ P〈0.05）. Hemodynamic changes were not significantly different between two group. The incidence rate of sore throat two hours after operation was 6. 5%（ n = 4） in the Air-Q group and 5%（ n = 3） in the Aura-i group. Conclusion Both Ambu Aura-i and Air-Q intubating laryngeal airway are effective conduits for beroptic-guided tracheal intubation,with advantages including simple operation,high success rate,and fewer complications,especially the Ambu Aura-i.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2016年第6期637-642,共6页
Acta Academiae Medicinae Sinicae
基金
北京协和医学院青年科研基金(3332013094)~~
