喉罩通气在小儿纤维支气管镜诊疗中的应用  

Application of Laryngeal Mask Ventilation on Bronchoscopic Procedure in Children

作　　者：冉建[1] 黎秀萍[1] 傅艳妮[2] 

机构地区：[1]广州医学院第一附属医院,广东广州510120 [2]中山大学第二附属医院,广东广州510120

出　　处：《实用医技杂志》2008年第22期2954-2955,共2页Journal of Practical Medical Techniques

摘　　要：目的:探讨喉罩通气麻醉应用于小儿纤维支气管镜诊疗的安全性和可行性。方法:选择行纤维支气管镜诊疗的小儿18例,男13例,女5例,年龄0.5岁～6岁,丙泊酚和舒芬太尼静脉麻醉诱导和维持,术中监测无创血压(NIBP)、心电图(EKG)、心率(HR)、脉搏氧饱和度(SpO2)和呼气末二氧化碳分压(PETCO2),根据患儿体重分别置入相应大小的喉罩,观测置入喉罩前(T0)、置入喉罩后1min(T1)、3min(T2)和5min(T3)的HR、MAP的变化,记录术中呛咳、体动、返流和误吸等不良反应。结果:置入喉罩前(T0)与置入喉罩后1min(T1)、3min(T2)和5min(T3)的HR、MAP的变化差异无显著性(P>0.05),18例患儿术中无1例出现呛咳、体动、返流和误吸等不良反应,SpO2维持在95%～100%。结论:喉罩通气全麻用于小儿纤维支气管镜的诊疗具有操作简单、安全性高、能有效维持呼吸道通畅、保证有效通气、血流动力学平稳,对呼吸循环影响小的优点。Objective To investigate the safety and feasibility of application of laryngeal mask ventilation on bronchoscopic procedure in children.Methods Eighteen children aged 0.5-6 years old （male 13 and female 5）were enrolled in the study. All children were induced and maintained with propofol and sufentanil, and noninvasive blood pressure （NIBP）, electrocardiogram （EKG）, heart rate （HR）, pulsatile oxygen saturation （SpO2） and end-tidal carbon dioxide （PETCO2） were monitored. Laryngeal mask of appropriate size was chose according to body weight, then HR and mean arterial pressure （MAP） were recorded instantly before and 1 min, 3 min and 5 min after laryngeal mask placement. Adverse effects including bucking, body movement, reflux and aspiration were recorded.Results Compared to those before laryngeal mask placement, no significant change in HR and MAP were observed 1 min, 3 min and 5 min after mask placement （P〉0.05）. In all the children, SpO2 was 95%-100%, and no any bucking, body movement, reflux and aspiration was observed.Conclusion Application of laryngeal mask ventilation under general anesthesia on bronchoscopic procedure in children is convenient to perform safely, affect respiratory and circulatory function little, and securely ensure patent airway, effective ventilation and smooth hemodynamics.

关 键 词：喉罩通气 全麻 小儿 纤维支气管镜诊疗 

分 类 号：R726.1[医药卫生—儿科]