目的 研制一种带着通气设备能讲话的声门上通气装置，以满足脑功能语言区手术中唤醒条件下监测、定位的临床需要，解决通气与讲话不能兼顾的难题。方法 根据咽喉部解剖及通气和讲话原理研制成Ⅰ型、Ⅱ型和Ⅲ型导管。临床应用60例，其中全麻手术40例，术毕患者清醒于拔管前让患者讲话；脑功能区手术术中唤醒时讲话20例。结果 60例患者术中通气良好，气道压和血气正常；患者清醒带管均能讲话，讲话的清晰度和流利程度Ⅱ型和Ⅲ型导管显著优于Ⅰ型，p<0.01。结论 作者研制的Ⅰ型、Ⅱ型和Ⅲ型导管，可安全实施全麻和机械呼吸，由于导管未占用气道和发音器官的共同通道，上端咽部气囊放气后可发音讲话。这种新型患者带管能讲话的声门上通气设备尤其是Ⅱ型和Ⅲ型通气效果满意，讲话清晰，患者易耐受，显著地提高了脑功能语言区手术麻醉的安全性和可控性。解决了语言功能术中唤醒麻醉带管讲话的难题。
Objective: Design some externalglottis breath catheter to solve the conflict between breath and speak in intraoperation wake-up. Methods: We designed and made three model catheters ( typeⅠ typeⅡ and typeⅢ). These catheters were used to 60 patients who had general anesthesia, including 20 paitents were intraoperation wake-uped . Ruselts: All paitents had good ventilation, air passage pressure and blood gas analysis were right. All could speak with catheter. TypeⅡ and type Ⅲ were distincter and smoother than typeⅠ(P<0.01). Conclusion: Patient can speak distinctly and smoothly with these catheter in operation. These series of catheters have good ventilation, were safety for mechanical ventilation and general anesthesia. TypeⅡ and type Ⅲ are better. These catheters solved the conflict between breath and speak in intraoperation wake-up, and can enhance safety of brain operation with intraoperation wake-up greatly.
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