小儿支气管异物取出术的麻醉体会  

The Understanding of Anesthesia for the Extraction of Infant Bronchial Foreign Body

作　　者：钱耀亮[1] 于涛[1] 卢振和[1] 张海波[1] 高崇荣[1] 

机构地区：[1]广州医学院第二附属医院,广东广州510260

出　　处：《现代医院》2004年第7期41-42,共2页Modern Hospitals

摘　　要：目的　探讨适合小儿支气管异物取出术的麻醉及用药方式。方法　对 32例小儿支气管异物取出术的麻醉用药方法进行分析。按用药方式分组比较麻醉效果 ,并比较高频喷射通气及侧管供氧的通气效果。结果　全部病例呼吸变化无明显差异 (P >0 0 5 )。术中各阶段脉搏变化大 :麻醉后较入室麻醉前脉搏明显增快 (P <0 0 5 ) ;置镜时单纯氯胺酮组较复合组明显增快 (P <0 0 5 )。置镜时SPaO2 明显低于麻醉后 (P<0 0 5 )和取出异物后 ,高频喷射通气组SPaO2 明显高于侧管供氧。结论　氯胺酮复合r -羟基丁酸钠麻醉 ,辅助高频喷射通气供氧对小儿支气管异物取出术是安全有效的方法。Objective To discuss the suitable anesthetic mode for infant bronchial foreign body. Methods To summary the anesthetic mode of infant bronchial foreign body of 32 cases (ASAⅡ～Ⅲ) in nearly 20 years retrospectively. To compare the anesthetic result of different medication and compare ventilation effect of high frequency jet ventilation with sideway-duct ventilation. Results There was no significant difference in the respiratory change for all cases (P>0.05). There were significant changes in pulse during the operation: the pulse was more faster in post-anesthesia than pre- anesthesia (P<0.05), and more faster in only ketamine group than compounding group (P<0.05). The SpaO 2 was obviously lower in putting laryngoscope than post-anesthesia and post-extracting foreign body (P<0.05), and higher significantly in high frequency jet ventilation than sideway-duct ventilation mode. Conclusion Ketamine compounding r-OH anesthesia, assisting with high frequency jet ventilation is a safe and effective method for the extraction of infant bronchial foreign body.

关 键 词：小儿 支气管异物 异物取出术 麻醉 氯胺酮 r-羟基丁酸钠 

分 类 号：R768.4[医药卫生—耳鼻咽喉科] R614.27[医药卫生—临床医学]