上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (05): 651-655.doi: 10.3969/j.issn.1674-8115.2020.05.014

• 论著·临床研究 • 上一篇    下一篇

超声评估全身麻醉喉罩和气管导管通气对胃进气的影响

高红梅1，鲍 杨1，李淑芸1，殷苏晴2，朱 玲2，杨立群2   

  1. 1.上海健康医学院附属嘉定区中心医院麻醉科，上海 201800；2.上海交通大学医学院附属仁济医院麻醉科，上海 200127
  • 出版日期:2020-05-28 发布日期:2020-05-28
  • 通讯作者: 杨立群，电子信箱：lqyang72721@126.com。
  • 作者简介:高红梅（1986—），女，主治医师，硕士；电子信箱：gaohongmei1986@163.com。
  • 基金资助:
    上海市卫生和计划生育委员会优秀学科带头人计划（2017BR042）。

Effect of laryngeal mask and endotracheal tube ventilation on gastric insufflation during general anesthesia with ultrasound evaluation

GAO Hong-mei1, BAO Yang1, LI Shu-yun1, YIN Su-qing2, ZHU Ling2, YANG Li-qun2   

  1. 1. Department of Anesthesiology, Jiading District Central Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201800, China; 2. Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2020-05-28 Published:2020-05-28
  • Supported by:
    Outstanding Academic Leaders' Program of Shanghai Municipal Health and Family Planning Commission (2017BR042).

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摘要： 目的·观察流线型气道喉罩（streamlined liner of pharynx airway，SLIPA）与胃进气的相关性。方法·纳入2017年9月—2018年5月于上海健康医学院附属嘉定区中心医院择期行全身麻醉下手术患者70例，采用随机数字表将患者区组随机分为SLIPA组（S组，n=35）和气管导管组（T组，n=35），分别于诱导前、插管（喉罩）后即刻、拔管（喉罩）前、拔管（喉罩）后即刻4个时间点进行胃窦部超声检查。通过超声测量胃窦区截面积（cross sectional area，CSA）和超声成像中“彗尾征”2种方式评估胃进气情况，记录并比较相应时间点的脉搏血氧饱和度（pulse oxygen saturation，SpO2）、呼气末二氧化碳分压（end-tidal pressure of carbon dioxide, PETCO2），气道峰压（peak inspiratory pressures，PIP）、CSA。结果·2组患者在麻醉期间的胃进气率比较，差异无统计学意义（P=0.894）；各个时间点的SpO2组间比较差异均无统计学意义（均P>0.05）；手术结束时S组PETCO2较T组明显增高（P=0.000）。结论·与气管导管相比，全身麻醉过程中SLIPA并不会增加胃进气的发生。

关键词: 流线型气道喉罩, 气管导管, 超声, 胃窦区截面积, 胃进气

Abstract:

Objective · To observe the correlation between streamlined liner of pharynx airway (SLIPA) and gastric insufflation. Methods · Seventy patients who underwent elective general anesthesia in Jiading District Central Hospital Affiliated to Shanghai University of Medicine & Health Sciences from September 2017 to May 2018 were included. They were randomly divided into SLIPA group (S group, n=35) and endotracheal tube group (T group, n=35). The gastric antrum ultrasonography was performed at four time points before induction, immediately after intubation (insertion of laryngeal mask), before extubation (laryngeal mask), and immediately after extubation (laryngeal mask), to measure the cross sectional area (CSA) of gastric insufflation. Gastric intake was assessed by ultrasonic measurement of CSA and "comet tail sign" in ultrasound imaging. Pulse oxygen saturation (SpO2), end-tidal pressure of carbon dioxide (PETCO2), peak inspiratory pressure (PIP) and CSA were recorded and compared at the corresponding time points. Results · There was no significant difference in gastric insufflation rate between the two groups during anesthesia (P=0.894). There was no significant difference in SpO2 at each time point between the two groups (all P>0.05). At the end of surgery, PETCO2 in group S was significantly higher than that in group T (P=0.000). Conclusion · Compared with endotracheal tube, the SLIPA does not increase gastric insufflation during general anesthesia.

Key words: steamlined liner of the pharynx airway (SLIPA), endotracheal tube, ultrasound, cross sectional area, gastric insufflation

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