胃镜喉罩在无痛超声胃镜检查中的应用效果

Application effect of gastroscope laryngeal mask in painless endoscopic ultrasonography

摘要:

目的 评价胃镜喉罩应用于无痛超声胃镜检查的可行性和安全性。方法 选取该院行无痛超声胃镜检查的患者50例，随机分为胃镜喉罩组和气管插管组。记录两组患者插管前（T₀）、插管后1 min（T₁）、拔管前1 min（T₂）和拔管后1 min（T₃）的平均动脉压（MAP）、心率（HR）、经皮动脉血氧饱和度（SpO₂）、T₁至T₂时点呼气末二氧化碳分压（PetCO₂）和气道峰压；同时记录麻醉药用量、手术时间、拔管时间和PACU监护时间；记录反流误吸及术后咽喉部并发症。结果 两组患者手术时间、T₁至T₂时点PetCO₂及气道峰压比较，差异均无统计学意义（P > 0.05）。与T₀时点比较，气管插管组T₁至T₃时点MAP明显升高，HR明显增快，且相应时点均高于胃镜喉罩组（P < 0.05）；胃镜喉罩组麻醉药用量少于气管插管组，拔管时间和PACU监护时间短于气管插管组，术后咽部不适明显少于气管插管组，差异均有统计学意义（P < 0.05）。两组患者均无反流误吸发生。结论 胃镜喉罩应用于无痛超声胃镜检查，术后患者咽喉部并发症发生率低，安全性高，较气管插管有一定优势。

Abstract:

Objective To evaluate the feasibility and safety of gastroscope laryngeal mask for painless endoscopic ultrasonography.Methods Fifty patients underwent painless endoscopic ultrasonography were randomly divided into two groups: gastroscope laryngeal mask group and endotracheal intubation group. Mean arterial pressure (MAP), heart rate (HR) and percutaneous arterial oxygen saturation (SpO₂) were recorded in both groups at 4 time points: before intubation (T₀), 1 min after intubation (T₁), before extubation (T₂) and 1 min after extubation (T₃). partial pressure of end-tidal carbon dioxide (PetCO₂) and airway peak pressure at T₁ to T₂ were recorded. Record anesthesia dosage, duration of surgery, extubation time, and PACU monitoring time. And to observe the availability of intraoperative aspiration of reflux and postoperative throat complications.Results There were no statistically significant differences between the two groups, such as duration of surgery, PetCO₂ and peak airway pressure at T₁ to T₂; In the endotracheal intubation group, MAP and HR at T₁ to T₃ were higher than at T₀ and at the same time points in the gastroscope laryngeal mask group (P < 0.05); Compared with endotracheal intubation group, anesthesia dosage, extubation time and PACU monitoring time in gastroscope laryngeal mask group were significantly reduced (P < 0.05); Endotracheal intubation group (8 cases) in patients with postoperative pharyngeal discomfort were significantly more than in the gastroscope laryngeal mask group (1 case) (P < 0.05); There was no intraoperative aspiration of reflux in both groups.Conclusion The gastroscope laryngeal mask used in painless endoscopic ultrasonography has low incidence of postoperative throat complications and high safety, and has certain advantages over tracheal intubation.