【摘要】：目的通過比較1歲以下嬰兒使用I-gel喉罩或Ambu喉罩的通氣效果,評(píng)價(jià)這兩款喉罩用于嬰兒全身麻醉氣道管理的有效性和安全性。方法選擇0~1歲擇期于泌尿外科行會(huì)陰部手術(shù)的患兒30例,采用抽簽法隨機(jī)分為I-gel喉罩組和Ambu喉罩組,每組15例。觀察并記錄兩組患兒的喉罩置入情況,包括置入成功率、成功置入喉罩所需時(shí)間(張口開始至行正常機(jī)械通氣的時(shí)間)、喉罩置入成功后的Brimacombe評(píng)分。分別于麻醉誘導(dǎo)后(T_0)、成功置入喉罩后呼氣末二氧化碳分壓(petCO2)正常時(shí)(T_1)、置入后10 min(T_2)、置入后20 min(T_3)、置入后30 min(T4)各時(shí)間點(diǎn),記錄血流動(dòng)力學(xué)數(shù)據(jù),于T_1至T4時(shí)間點(diǎn)記錄氣道密封壓(LP)和呼吸動(dòng)力學(xué)數(shù)據(jù),計(jì)算每千克體重吸入潮氣量、呼出潮氣量、漏氣分?jǐn)?shù)(Lf)和呼氣阻力(Re)。記錄喉罩置入后患兒的不良反應(yīng)發(fā)生情況。結(jié)果兩組患兒喉罩置入成功率和喉罩成功置入后Brimacombe評(píng)分的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05),I-gel喉罩組成功置入喉罩所需時(shí)間顯著短于Ambu喉罩組(P0.05)。I-gel喉罩組T_1至T_4時(shí)間點(diǎn)的LP均顯著高于Ambu喉罩組(P值均0.05)。兩組患兒各時(shí)間點(diǎn)的平均動(dòng)脈壓、心率、脈博血氧飽和度的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05)。Ambu喉罩組T_1至T4時(shí)間點(diǎn)的呼氣峰流速均顯著高于I-gel喉罩組同時(shí)間點(diǎn)(P值分別0.01、0.05),呼氣阻力均顯著低于I-gel喉罩組同時(shí)間點(diǎn)(P值分別0.01、0.05);Ambu喉罩組T_1時(shí)間點(diǎn)的吸入潮氣量、呼出潮氣量、肺動(dòng)態(tài)順應(yīng)性、肺靜態(tài)順應(yīng)性均顯著高于I-gel喉罩組同時(shí)間點(diǎn)(P值分別0.05、0.01)。Ambu喉罩組患兒胃脹氣發(fā)生率顯著高于I-gel組(P0.05),兩組間其他不良反應(yīng)發(fā)生率的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05)。結(jié)論 I-gel喉罩和Ambu喉罩均能滿足1歲以下嬰兒全身麻醉機(jī)械通氣的通氣效果。I-gel喉罩置入時(shí)間更短,氣道密封性更優(yōu),嬰兒術(shù)后不良反應(yīng)發(fā)生率更低,更有利于麻醉醫(yī)師對(duì)氣道進(jìn)行控制和管理。
[Abstract]:Objective to compare the ventilation effect of I-gel laryngeal mask or Ambu laryngeal mask in infants under 1 year old, and to evaluate the effectiveness and safety of these two laryngeal masks in the management of airway under general anesthesia in infants. Methods 30 children aged 0 to 1 year who underwent perineal surgery in urology were randomly divided into I-gel laryngeal mask group and Ambu laryngeal mask group with 15 cases in each group. The laryngeal mask placement in the two groups was observed and recorded, including the success rate, the time taken to successfully insert the laryngeal mask (the time from the beginning of opening to normal mechanical ventilation), and the Brimacombe score after successful placement of laryngeal mask. After anesthesia induction (T 鈮，

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