中文摘要：

目的：前瞻性研究比较静脉麻醉下经喉罩、经口腔和经鼻腔进行纤维支气管镜检查活检的手术安全性。方法2009年4月至2012年12月共150例患者接受无痛支气管镜检查，按随机方法分为喉罩组、非喉罩经鼻组（经鼻组）和非喉罩经口组（经口组），每组各50例。分别记录支气管镜进入声门时间、总检查时间、术中血氧饱和度低于80％使操作暂停次数和手术后鼻咽部不适等情况。结果总手术时间喉罩组短于经鼻组和经口组（ P＜0.01）。喉罩组支气管镜进入声门时间明显短于经鼻组和经口组（ P＜0.01）。经鼻组18例、经口组15例术中出现低氧而中断操作（ P＞0.05）。术后经鼻组19例患者出现鼻部不适，其他两组没有鼻部不适的患者。三组患者均无不良记忆和恐惧，再次手术的接受程度均为100％。结论在无痛支气管镜操作过程中，使用喉罩可以减少支气管镜进入声门时间并保证术中有效供氧，从而明显减少了因缺氧造成的操作暂停，使手术时间明显缩短，提高了患者耐受性和手术安全性。

英文摘要：

Objective To evaluate the usefulness and safety of bronchoscopy by the laryngeal mask airway （LMA） compared with by nose and by mouth.Methods Between April 2009 and Dec 2012, we prospectively studied 150 analgesia brochoscopy in the operating theater of the our hospital.All the patients were randomly assigned by computer to LMA group , non-LMA by nose group （ NLBN ） and non-LMA by mouth group（NLBM） according the way of bronchoscopy.Each group had 50 cases.We recorded the time of bronchoscopy just through subglottic , total operation time , the times of blood oxygen less than 80%so as to suspend procedure and so on.Results Intergroup comparisons showed no difference in gender , age, and the successful rate of biopsy （ P〉0.05）.The time of bronchoscopy just through subglottic in LMA group was lower than that in NLBN group and in NLBM group significantly （P〈0.01）, and no difference between two latter groups（P〉0.05）.Also, total operation time of LMA group was higher than that of others （P 〈0.05 ） , but no difference between the latter two groups.There were 18 cases in NLBN group and 15 cases in NLBM group respectively , which were suspended procedure during operation due to low oxygen , and the difference did not reach statistical sense （P〉0.05）.There were 19 patients presented with nasal discomfort after operations in NLBN Group.The patients in all the three groups had no bad memory or fear , and the acceptance rate of reoperation was all 100%.In general, as to the cases of the patients who presented with pharyngeal discomfort and abnormal pronunciation , there was significance difference between LMA Group and NLBN Group and also between LMA Group and NLBM Group , while the difference between NLBN Group and NLBM Group was not statistically significan.Conclusion The use of the LMA during FFB is safe, provides excellent patient comfort , reduces the time of bronchoscopy just through subglottic so as to decrease the total operation time , and is better to control the situation o