天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (6): 632-636.doi: 10.11958/20253402

• 应用研究 • 上一篇    下一篇

GMA郁金香喉罩与气管插管在机器人辅助腹腔镜直肠切除术中的应用对比

胡小彤(), 王蕾, 杨涛△()   

  1. 天津市人民医院， 南开大学第一附属医院麻醉科 （邮编300121）
  • 收稿日期:2025-11-26 修回日期:2026-02-06 出版日期:2026-06-15 发布日期:2026-06-15
  • 通讯作者: △E-mail：yangtao@nankai.edu.cn
  • 作者简介:胡小彤（1990），女，医师，主要从事全麻患者气道管理研究。E-mail：1316333070@qq.com
  • 基金资助:
    国家自然科学基金青年科学基金项目(82102248);天津市科技计划项目(23JCQNJC01280)

Comparison of GMA-Tulip laryngeal mask and tracheal intubation in robotic-assisted laparoscopic proctectomy

HU Xiaotong(), WANG Lei, YANG Tao△()   

  1. Department of Anesthesiology, Tianjin Union Medical Center, the First Affiliated Hospital of Nankai University, Tianjin 300121, China
  • Received:2025-11-26 Revised:2026-02-06 Published:2026-06-15 Online:2026-06-15
  • Contact: △E-mail：yangtao@nankai.edu.cn

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摘要：

目的 比较新型免充气喉罩（GMA郁金香喉罩）与气管插管在机器人辅助腹腔镜下直肠切除术中的气道管理效果差异。方法 纳入接受全身麻醉下行机器人辅助腹腔镜直肠切除术的60例患者，按随机数字表法分为GMA郁金香喉罩组（喉罩组）和气管插管组（插管组），每组30例。观察喉罩组头低脚高位时的气道峰压（Ppeak）及口咽漏气压（OLP），比较2组置入次数及置入时间，置入前（T1）、置入即刻（T2）、拔管或拔喉罩前（T3）、拔除即刻（T4）的心率（HR）、平均动脉压（MAP），入室后（T0）、手术开始后第1、2 h动脉血氧分压[p（O2）]，苏醒期躁动、呛咳、咽痛、声嘶发生情况，以及术后7 d肺部并发症（PPCs）情况。结果 喉罩组头低脚高位时的Ppeak低于OLP（P<0.05），其中4例患者头低脚高位时的Ppeak高于OLP；喉罩组置入时间短于插管组（P<0.05），2组置入次数差异无统计学意义（P>0.05）。2组内T2、T4的HR、MAP分别高于本组T1、T3（P<0.05）；2组间T1、T3的HR、MAP比较，差异无统计学意义（P>0.05），喉罩组T2和T4的HR、MAP低于插管组（P<0.05）。2组T0、手术开始后第1 h及第2 h动脉血p（O2）比较，差异无统计学意义（P>0.05）；喉罩组苏醒期躁动、呛咳发生率低于插管组（P<0.05），2组苏醒期咽痛、声嘶发生率及术后7 d PPCs发生率差异无统计学意义（P>0.05），喉罩组苏醒期并发症总发生率及术后7 d PPCs总发生率低于插管组（P<0.05）。结论 全麻下行机器人辅助腹腔镜直肠切除术中应用GMA郁金香喉罩进行气道管理时，在维持血流动力学稳定及减少术后并发症方面较气管插管具有优势。

关键词: 直肠切除术, 机器人手术, 全身, 麻醉, 血流动力学, 气道管理, 手术后并发症, GMA郁金香喉罩

Abstract:

Objective To compare the differences in airway management between GMA-Tulip laryngeal mask and tracheal intubation in robot-assisted laparoscopic rectal resection surgery. Methods Data were collected from 60 patients who underwent robot-assisted laparoscopic rectal resection under general anesthesia in Tianjin Union Medical Center, and patients were randomly divided into the GMA-Tulip laryngeal mask group and the endotracheal intubation group using a random number table, with 30 cases in each group. The peak airway pressure (Ppeak) in the trendelenburg position and oropharyngeal leak pressure (OLP) were observed in the GMA-Tulip laryngeal mask group. The number and duration of insertion, heart rate (HR) and mean arterial pressure (MAP) before insertion (T1), immediately after insertion (T2), before extubation and removal of the laryngeal mask (T3), immediately after extubation (T4), the arterial partial pressure of oxygen [p（O2）]after entering the operating room (T0), at the 1st and 2nd hours, the occurrence of restlessness, choking, sore throat and hoarseness during the anesthetic emergence and the occurrence of postoperative pulmonary complications (PPCs) whinin 7 days were compared between the two groups. Results The Ppeak of the trendelenburg position was lower than that of the OLP in the GMA-Tulip laryngeal mask group. The insertion time of the GMA-Tulip laryngeal mask group was shorter than that of intubation group. There was no statistically significant difference in the number of insertion between the two groups (P > 0.05). The HR and MAP at T2 and T4 were respectively higher than those at T1 and T3 within the same group (P < 0.05), and there were no statistically significant differences in HR and MAP at T1 and T3 between the two groups (P > 0.05). The HR and MAP of T2 and T4 were lower in the GMA-Tulip laryngeal mask group than those of the tracheal intubation group (P < 0.05). There was no statistically significant difference in p（O2）at T0, 1st and 2nd hours intraoperatively between the two groups (P > 0.05). There were no statistically significant differences in the incidence of sore throat and hoarseness during the anesthetic emergence, as well as the incidence of PPCs within 7 days between the two groups (P > 0.05). The total incidence of complications during emergence and the total incidence of PPCs within 7 days were lower in the GMA-Tulip laryngeal mask group than those in the endotracheal intubation group (P < 0.05). Conclusion The application of the GMA-Tulip laryngeal mask for airway management during robot-assisted laparoscopic rectal resection under general anesthesia offers advantages over endotracheal intubation in maintaining hemodynamic stability and reducing postoperative complications.

Key words: proctectomy, robotic surgical procedures, anesthesia, general, hemodynamics, airway management, postoperative comlications, GMA-Tulip

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