下颌第二恒磨牙远中舌侧尖间距作为成人喉罩型号选择方法的可行性

目的探讨下颌第二恒磨牙远中舌侧尖间距作为成人喉罩型号选择方法的可行性。方法选择使用喉罩行择期手术的患者68例,随机分为两组：标准体重（B组）和下颌第二恒磨牙远中舌侧尖间距（D组）,每组34例,根据结果选择相应型号的喉罩。患者予全麻诱导,插入选定型号的喉罩。行喉罩漏气和纤支镜下对位检查,满意后行机械通气。术毕患者清醒后拔除喉罩,观察并记录喉罩上血丝情况。术后随访患者咽喉部并发症情况。结果 D组纤支镜下3和4级的例数（32例）多于B组（26例）,差异有统计学意义（P〈0.05）。两组中纤支镜下1和2级行正压通气成功8例,失败2例,镜下3和4级行正压通气成功58例,无失败病例,纤支镜下分级与喉罩正压...

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Published in复旦学报（医学版） Vol. 44; no. 1; pp. 53 - 57
Main Author 陈春欢 金建华 唐俊 张堃
Format Journal Article
LanguageChinese
Published 复旦大学附属金山医院麻醉科 上海201508%复旦大学附属上海市第五人民医院麻醉科 上海200240 2017
Subjects
喉罩
型号
标准体重
第二恒磨牙
远中舌侧尖
远中舌侧尖
size
standard body weight
second molar
型号
第二恒磨牙
喉罩
laryngeal mask airway
distolingular cusp
标准体重
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Summary:目的探讨下颌第二恒磨牙远中舌侧尖间距作为成人喉罩型号选择方法的可行性。方法选择使用喉罩行择期手术的患者68例,随机分为两组：标准体重（B组）和下颌第二恒磨牙远中舌侧尖间距（D组）,每组34例,根据结果选择相应型号的喉罩。患者予全麻诱导,插入选定型号的喉罩。行喉罩漏气和纤支镜下对位检查,满意后行机械通气。术毕患者清醒后拔除喉罩,观察并记录喉罩上血丝情况。术后随访患者咽喉部并发症情况。结果 D组纤支镜下3和4级的例数（32例）多于B组（26例）,差异有统计学意义（P〈0.05）。两组中纤支镜下1和2级行正压通气成功8例,失败2例,镜下3和4级行正压通气成功58例,无失败病例,纤支镜下分级与喉罩正压通气成功率之间有明显相关性（P〈0.05）。两组中同一患者按两种方法选择的型号不一致时,按B组方法选出的型号纤支镜下1和2级为5例,镜下3和4级为1例;按D组方法选出的型号纤支镜下无1级和2级病例,镜下3和4级为6例;两组差异有统计学意义（P〈0.05）。结论根据下颌第二恒磨牙远中舌侧尖间距选择喉罩型号的方法可增加喉罩插入后与声门最佳对合的概率,从而提高喉罩正压通气的成功率,在临床实践中具有可行性。
Bibliography:laryngeal mask airway; size; standard body weight; second molar; distolingular cusp
CHEN Chun huan1 , JIN Jian-hua1 , TANG Jun2, ZHANG Kun 1 （ 1 Department of Arzesthesia , J inshan Hospital, Fudan University, Shanghai 201508, China ; 2 Department of Anesthesia, the Fifth Hospital of Shanghai , Fudan University, Shanghai 200240, China）
Objective To introduce a new method to select laryngeal mask airway（ LMA） size,which is based on the space between bilateral distolingular cusps of mandibular second molars,and to investigate the clinical feasibility of the new method. Methods Sixty-eight patients undergoing selective operation under general anesthesia were included and assigned randomly to 2 groups. LMA sizes in group B were selected by the standard body weights of patients,and it in group D were selected by the distance between bilateral distolingular cusps of mandibular second molars. All patients were inserted LMA after routine general anesthesia induction. Air leak and fibreoptic evaluation were placed after
ISSN:1672-8467
DOI:10.3969/j.issn.1672-8467.2017.01.009