山东第二医科大学学报

目的 分析不同类型喉罩在全身麻醉下宫腔镜日间手术中漏气的原因。方法 拟行全身麻醉下宫腔镜日间手术患者120例，美国麻醉医师协会分级(ASA)Ⅰ～Ⅱ级，年龄18～65岁，排除喉罩全麻禁忌证，采用随机数字表法将患者随机分为3组，分别为普通单管喉罩组(C组)、可弯曲喉罩组(F组)、双管喉罩组(S组),根据患者体重选择不同型号的喉罩，常规麻醉诱导后置入喉罩，用纤支镜检查定位，观察不同类型喉罩在术中漏气发生率和漏气原因。结果 120例患者均成功置入喉罩，F组剔除1例因置入喉罩后因喉罩型号过小漏气患者，共119例患者纳入分析。出现喉罩漏气7例，其中C组2例、F组2例、S组3例，漏气发生率在各组之间无统计学意义(P>0.05)。7例患者发生喉罩漏气时纤支镜检查发现喉罩位置均无变化，均存在声门闭合现象。结论 不同类型的喉罩在妇科宫腔镜日间手术的全身麻醉过程中漏气发生率方面没有差异，术中喉罩漏气原因主要与声门闭合导致的气道压力升高有关。

Objective The present study aims to analyze the causes of air leakage of different types of laryngeal mask airway(LMA) during hysteroscopic day surgery under general anesthesia.Methods The study enrolled 120 American Society of Anesthesiologists(ASA) Ⅰ or Ⅱ patients, who were aged between 18 to 65 without any laryngeal mask anesthesia contraindications.Patients were randomly divided into three groups-classic laryngeal mask group(group C),flexible laryngeal mask group(group F) and supreme laryngeal mask group(group S).Different types of LMA were selected according to the weight of the patients.After routine anesthesia induction, LMA was inserted, and the position was examined by fiberoptic bronchoscopy to observe the incidence and causes of air leakage during the operation.Results All 120 patients were successfully implanted with LMA.One patient with air leakage in group F was excluded due to the small size of LMA.Finally, a total of 119 patients were included in the following analysis.There were seven cases of laryngeal mask air leakage, including two cases in group C,two cases in group F and three cases in group S,with no significant difference in the incidence of air leakage among the three groups(P>0.05).Additionally, all the seven patients had glottis closure during their laryngeal mask air leakage without any change in the position of the laryngeal mask.Conclusion There is no difference in the incidence of air leakage among different types of LMA during general anesthesia in gynecological hysteroscopic day surgery.The main cause of air leakage of LMA during the operation is related to the increase of airway pressure caused by glottis closure.