全麻下高频喷射通气在小儿气道异物取出术的应用(附52例病例分析)  

The Application of General Anesthesia High-frequency Jet Ventilation in the Infantile Air Passage Foreign Body Extraction

作　　者：杨少玲[1] 陈群先[1] 

机构地区：[1]广东省茂名市人民医院,广东茂名525000

出　　处：《河北医学》2005年第7期604-605,共2页Hebei Medicine

摘　　要：目的:观察静脉复合全麻下高频喷射通气(HFJV)在小儿气道异物取出术的临床效果。方法:患儿在进入手术室前肌注氯胺酮4～8mg/kg,待患儿安静入睡后进手术室,开通静脉通道后缓慢注射羟丁酸钠(r-OH)80～100mg/kg,约10min后以1%地卡因作喉部表面雾化喷入,较大患儿于环甲膜穿刺注入1%地卡因1ml,5min后即可手术,手术时间超过90min者,可追加氯胺酮、r-OH等。术中HFJV采用国产KR-Ⅱ呼吸机,电控气动进行喷射通气,频率根据缺氧程度选用144～200次/min,气源驱动压0.6～1.2kg/cm2。结果:术中麻醉平稳、缺O2改善,52例气管、支气管异物的患儿在静脉复合全麻下行高频喷射通气均顺利完成手术。结论:静脉复合全麻下行HFJV在小儿气道异物取出术的应用效果是确切的。Objective: To observe the clinical effect of the HFJV under general intravenous combined anesthesia in the infantile air passage foreign body extraction. Method: Before entering the operating room, the infant patient was injected with ketamine of 4～8 mg/kg. Then the sleeping infant patient was sent to the operating room, and the r-OH of 80～100 mg/kg was slowly injected after the intravenous track was ready there. 10 minutes later, the 1% dicaine was sprayed nebulizationally via the throat, and for the bigger infant, 1% dicaine of 1 ml was injected by intercricocentesis. And the operation was conducted 5 minutes later. For the patients whose operation time exceeded 90 minutes, the ketamine and r-OH would have been added for the second time. During the operation, the domestic KR-II respirator and electric-control pneumatic method were used for jet ventilation with the frequency of 144～200 times/a minute chosen upon the oxygen lack level and the air source driving pressure being 0.6～1.2 kg/cm^2. Result: During the operation, the anesthesia was stable and the oxygen lack level had been improved. The 52 cases of operation of infants with foreign bodies in trachea or bronchus were completed smoothly by the HFJV under the complete intravenous combined anesthesia. Conclusion: The application of complete intravenous combined anesthesia HFJV is effective in the infantile air passage foreign body extraction.

关 键 词：高频喷射通气 小 儿 气管异物取出 

分 类 号：R726.1[医药卫生—儿科]