肌松剂下喉罩通气在小儿纤支镜气管异物取出术中的应用研究  

Application research on muscle relaxant and controlled respiration in tracheal foreign body removal with fibre bronchoscope using Laryngeal mask Airway children

作　　者：沈丽萍[1] 刘林生[2] 苏应准[2] 

机构地区：[1]云南省第二人民医院麻醉科,昆明650021 [2]佛山市第一人民医院麻醉科,广东佛山528000

出　　处：《中国医学前沿杂志（电子版）》2014年第4期52-56,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨肌松剂下喉罩通气控制呼吸在小儿纤支镜气管异物取出术的应用效果。方法 111例气管异物患儿均行全身麻醉,按通气方法分A、B、C 3组。A组采用高频通气法,B组采用肌松剂下喉罩通气法,C组采用非插管静脉全麻下自主呼吸法。分别记录3组患儿手术时间、苏醒时间、平均动脉压(MAP)、血氧饱和度(SpO2)、血压(BP)、心率(HR)、脑电双频指数(BIS)等指标,观察喉头水肿等术中及术后并发症情况。结果 A组患儿手术时间为(41.6±15.5)分钟,B组患儿手术时间为(26.5±13.2)分钟,C组患儿手术时间为(53.5±16.8)分钟,经方差分析,P<0.05,组间差异具有显著性。A组患儿手术期间钳取异物时(T3)时刻SpO2水平为(91.5±7.6)%,B组患儿手术期间T3时刻SpO2水平为(98.8±6.3)%,C组患儿手术期间T3时刻SpO2水平为(89.2±8.2)%,P<0.05,组间差异有显著性。A组患儿手术并发症发生率为13.3%,B组患儿手术并发症发生率为4.2%,C组患儿手术并发症发生率为27.2%,经卡方检验,P<0.05,组间差异有显著性。结论肌松剂下喉罩通气行气管异物取出术术中并发症少,且极大地方便了手术操作,缩短了手术时间,提高了手术、麻醉的安全性。Objective To investigate the application effect of muscle relaxant and controlled respiration in tracheal foreign body removal with ifbre bronchoscope using positive pressure ventilation with facemask in children. Methods 111 children of general anesthesia with tracheal foreign body were divided into group A, B and group C according to ventilation methods. Group A were treated with high frequency ventilation, group B were provided laryngeal mask airway with muscle relaxant, and group C were provided spontaneous breathing method under non-intravenous cannula general anesthesia. The operation time, recovery time, MAP, SpO2, BP, HR, BIS were recorded. Laryngeal edema and postoperative complications were observed. Results The operation time in group A and group B were (41.6±15.5) min and (26.5±13.2) min, group C were (53.5±16.8) min, respectively. There was signiifcant difference between two groups via T test (P < 0.05). The average level of SpO2 during operationT3 in group A and group B were (91.5±7.6)%and (98.8±6.3)%, group C were (89.2±8.2)%, respectively. There was signiifcant difference between two groups (P<0.05). The postoperative complication rate in group A, B and C were 13.3%, 4.2%and 27.2%, respectively. There was signiifcant difference between two groups via Chi-square test (P<0.05). Conclusion Providing oxygen with positive pressure ventilation with facemask in tracheal foreign body removal has less complication,&nbsp;covenient operation, short operation time and more safe operation and anesthesia.

关 键 词：小儿 纤维支气管镜 气管异物 肌松剂 喉罩通气 

分 类 号：R726.1[医药卫生—儿科]