全身麻醉手术中气管插管和喉罩通气道对术后肺部并发症的影响

doi:10.16352/j.issn.1001-6325.2024.09.1314

基础医学与临床 ›› 2024, Vol. 44 ›› Issue (9): 1314-1319.doi: 10.16352/j.issn.1001-6325.2024.09.1314

全身麻醉手术中气管插管和喉罩通气道对术后肺部并发症的影响

彭煜, 易杰^*

中国医学科学院北京协和医学院北京协和医院麻醉科,北京 100730

收稿日期:2024-03-07 修回日期:2024-05-11 出版日期:2024-09-05 发布日期:2024-08-30
通讯作者: ^*easyue@163.com
基金资助:
国家高水平医院临床研究基金(2022-PUMCH-B-006);首都发展科研专项基金(2018-2-4013)

Effects of endotracheal tube and laryngeal mask airway on postoperative pulmonary complications in general anesthesia

PENG Yu, YI Jie^*

Department of Anesthesiology, Peking Union Medical College Hospital, CAMS ＆ PUMC, Beijing 100730, China

Received:2024-03-07 Revised:2024-05-11 Online:2024-09-05 Published:2024-08-30
Contact: ^*easyue@163.com

摘要/Abstract

摘要： 全身麻醉(全麻)手术是否出现术后肺部并发症(PPCs)是影响患者预后的一大关键因素。选择不同的气道管理工具能否影响PPCs的发生,尚无充分临床证据证实。全麻手术中应用的气道管理工具可以分为两大类:声门上气道管理工具和声门下气道管理工具,喉罩通气道(LMA)和气管插管(ETT)分别是其中的典型代表,也是如今全麻手术中应用最为广泛的两种气道管理工具。因此,有必要对全麻手术中这两个主流气道管理工具对术后肺部并发症的影响做一综述,为临床上全麻手术时气道管理工具的选择提供理论基础。

关键词: 气管插管, 喉罩通气道, 术后肺部并发症

Abstract: Postoperative pulmonary complications (PPCs) after general anesthesia surgery significantly affect patient prognosis. However, there′s insufficient evidence to confirm if different airway management tools influence PPCs. Airway management tools used in general anesthesia surgery can be divided into two categories: supraglottic and subglottic. Among them, the laryngeal mask airway (LMA) and endotracheal tube (ETT) are typical representatives and are the two most widely used airway management tools in general anesthesia surgery. Therefore, it is necessary to review and evaluated the effects of these two mainstream airway management tools in general anesthesia surgery on PPCs, thus providing a theoretical basis for the selection of airway management tools during general anesthesia surgery in clinical practice.

Key words: endotracheal tube, laryngeal mask airway, postoperative pulmonary complications

中图分类号:

R614.2

彭煜, 易杰. 全身麻醉手术中气管插管和喉罩通气道对术后肺部并发症的影响[J]. 基础医学与临床, 2024, 44(9): 1314-1319.

PENG Yu, YI Jie. Effects of endotracheal tube and laryngeal mask airway on postoperative pulmonary complications in general anesthesia[J]. Basic & Clinical Medicine, 2024, 44(9): 1314-1319.

参考文献 23

[1]	Lusquinhos J, Tavares M, Abelha F. Postoperative pulmonary complications and perioperative strategies: a systematic review[J]. Cureus, 2023, 15: e38786. doi: 10.7759/cureus.38786.
[2]	Patel SK, Bansal S, Puri A, et al. Correlation of perioperative atelectasis with duration of anesthesia, pneumoperitoneum, and length of surgery in patients undergoing laparoscopic cholecystectomy[J]. Cureus, 2022, 14: e24261. doi: 10.7759/cureus.24261.
[3]	Andualem AA, Yesuf KA. Incidence and associated factors of postoperative hypoxemia among adult elective surgical patients at Dessie Comprehensive Specialized Hospital: an observational study[J]. Ann Med Surg (Lond), 2022, 78: 103747. doi: 10.1016/j.amsu.2022.103747.
[4]	Barreveld AM, Mccarthy RJ, Elkassabany N, et al. Opioid stewardship program and postoperative adverse events: a difference-in-differences cohort study[J]. Anesthesiology, 2020, 132: 1558-1568. doi: 10.1097/ALN.0000000000003238.
[5]	Wang Z, Xing L, Cui H, et al. A nomogram for predicting the mortality of patients with acute respiratory distress syndrome[J]. J Healthc Eng, 2022, 2022: 5940900. doi: 10.1155/2022/5940900.
[6]	Zhou J, Wang C, Lv R, et al. Protective mechanical ventilation with optimal PEEP during RARP improves oxygenation and pulmonary indexes[J]. Trials, 2021, 22: 351. doi: 10.1186/s13063-021-05310-9.
[7]	Al-Ruweidi M, Ali FH, Shurbaji S, et al. Dexamethasone and transdehydroandrosterone significantly reduce pulmonary epithelial cell injuries associated with mechanical ventilation[J]. J Appl Physiol (1985), 2021, 130: 1143-1151. doi: 10.1152/japplphysiol.00574.2020.
[8]	Wang Y, Xie W, Feng Y, et al. Epithelial derived exosomes promote M2 macrophage polarization via Notch2/SOCS1 during mechanical ventilation[J]. Int J Mol Med, 2022, 50. doi: 10.3892/ijmm.2022.5152.
[9]	Niu J, Hu R, Yang N, et al. Effect of intratracheal dexmedetomidine combined with ropivacaine on postoperative sore throat: a prospective randomised double-blinded controlled trial[J]. BMC Anesthesiol, 2022, 22: 144. doi: 10.1186/s12871-022-01694-6.
[10]	Van Diepen A, Bakkes T, De Bie AJR, et al. Evalua-tion of the accuracy of established patient inspiratory effort estimation methods during mechanical support ventilation[J]. Heliyon, 2023, 9: e13610. doi: 10.1016/j.heliyon.2023.e13610.
[11]	Kheterpal S, Vaughn MT, Dubovoy TZ, et al. Sugam-madex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (STRONGER): a multicenter matched cohort analysis[J]. Anesthesiology, 2020, 132: 1371-1381. doi: 10.1097/ALN.0000000000003256.
[12]	Simon LV, Torp KD. Laryngeal mask airway[M]. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Klaus Torp declares no relevant financial relationships with ineligible companies. 2024:1-177.
[13]	Hunter JM, Aziz MF. Supraglottic airway versus tracheal intubation and the risk of postoperative pulmonary complications[J]. Br J Anaesth, 2021, 126: 571-574. doi: 10.1016/j.bja.2020.12.015.
[14]	Yang LQ, Zhu L, Shi X, et al. Postoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation[J]. Anaesthesia, 2023, 78: 953-962. doi: 10.1111/anae.16030.
[15]	Andreason SA, Lahey Z, Zhao D, et al. Mitochondrial genome datasets for the sweetpotato weevil, Cylas formicarius elegantulus (Coleoptera: Brentidae), collected in the United States[J]. Data Brief, 2023, 49: 109432. doi: 10.1016/j.dib.2023.109432.
[16]	Zhu L, Shi X, Yin S, et al. Effectiveness and pulmonary complications of perioperative laryngeal mask airway used in elderly patients (POLMA-EP trial): study protocol for a randomized controlled trial[J]. Trials, 2019, 20: 260. doi: 10.1186/s13063-019-3351-2.
[17]	林雨琪, 易杰. 喉罩全麻最佳机械通气模式的研究进展[J]. 基础医学与临床, 2023, 43: 842-847. doi: 10.16352/j.issn.1001-6325.2023.05.0842.
[18]	Li C, Lou Y, Shen Y, et al. Unilateral lingual nerve and hypoglossal nerve injury caused by a novel laryngeal mask airway: a case report[J]. Braz J Anesthesiol, 2022, 72: 666-668. doi: 10.1016/j.bjane.2021.10.014.
[19]	Zaman B, Noorizad S, Safari S, et al. Efficacy of laryngeal mask airway compared to endotracheal tube: a randomized clinical trial[J]. Anesth Pain Med, 2022, 12: e120478. doi: 10.5812/aapm.120478.
[20]	Jia Y, Zhang Y, Wang Z, et al. Influence of endotracheal tube and laryngeal mask airway for general anesthesia on perioperative adverse events in patients undergoing laparosco-pic hysterectomy: a propensity score-matched analysis[J]. J Res Med Sci, 2023, 28: 88. doi: 10.4103/jrms.jrms_384_22.
[21]	Hammer M, Santer P, Schaefer MS, et al. Supraglottic airway device versus tracheal intubation and the risk of emergent postoperative intubation after general anaesthesia in adults: a retrospective cohort study[J]. Br J Anaesth, 2021, 126: 738-745. doi: 10.1016/j.bja.2020.10.040.
[22]	Li Y, Yuan X, Sun B, et al. Rapid-flow expulsion maneuver in subglottic secretion clearance to prevent ventilator-associated pneumonia: a randomized controlled study[J]. Ann Intensive Care, 2021, 11: 98. doi: 10.1186/s13613-021-00887-5.
[23]	Puyo CA, Earhart A, Staten N, et al. Endotracheal intubation results in acute tracheal damage induced by mtDNA/TLR9/NF-kappaB activity[J]. J Leukoc Biol, 2019, 105: 577-587. doi: 10.1002/JLB.5A0718-254RR.

全身麻醉手术中气管插管和喉罩通气道对术后肺部并发症的影响

Effects of endotracheal tube and laryngeal mask airway on postoperative pulmonary complications in general anesthesia

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 23

相关文章 2

编辑推荐

Metrics

本文评价

[1]	张雨, 韩悦, 朱倩梅, 周会影, 苗煦涵, 姚晶曼, 刘子嘉, 申乐. 老年患者电视胸腔镜手术后肺部并发症的危险因素分析[J]. 基础医学与临床, 2023, 43(12): 1847-1851.
[2]	刘安雷, 李妍, 朱华栋, 刘继海, 李毅, 徐军, 杨惊. 床旁加强可视喉镜气管插管培训在急诊困难气道插管教学中的作用[J]. 基础医学与临床, 2023, 43(1): 200-203.