支撑喉镜下小儿喉乳头状瘤切除术麻醉处理  

Children under the self-retaining laryngoscope laryngeal papilloma surgery to deal with anesthesia

作　　者：李大珍[1] 彭明清[1] 石远[1] 

机构地区：[1]重庆医科大学附属儿童医院麻醉科,400014

出　　处：《重庆医学》2009年第9期1038-1039,共2页Chongqing medicine

摘　　要：目的探讨支撑喉镜下小儿喉乳头状瘤切除术麻醉处理方式。方法小儿喉乳头状瘤切除术32例,其中Ⅰ度喉梗阻(简称Ⅰ)15例,Ⅱ度喉梗阻(简称Ⅱ)12例,Ⅲ度喉梗阻(简称Ⅲ)5例。丙泊酚复合芬太尼或丙泊酚复合瑞芬太尼静脉麻醉,气管插管者采用呼吸暂停法。记录麻醉诱导前、手术开始、术中10 min、手术结束时平均动脉压(MAP)、心率(HR)、氧饱和度(SpO2),记录麻醉诱导时低氧血症、气管插管以及术中声带活动发生情况。结果各时点MAP、HR、SpO2差异无统计学意义(P>0.05)。与Ⅰ相比,Ⅱ、Ⅲ低氧血症与气管插管发生率高(P<0.05),与Ⅱ相比,Ⅲ低氧血症与气管插管发生率高(P<0.05);与Ⅰ相比,Ⅱ术中声带活动发生率差异无统计学意义(P>0.05),Ⅲ术中声带活动发生率低于Ⅰ和Ⅱ(P<0.05)。结论小儿喉乳头状瘤切除术麻醉处理应根据患者的具体情况选择麻醉用药和麻醉方式,静脉复合麻醉和呼吸暂停法在小儿喉乳头状瘤切除术具有一定的可行性。Objective To investigate children under the self-retaining laryngoscope laryngeal papilloma surgery to deal with anesthesia. Methods Pediatric laryngeal papilloma excision 32 cases, Ⅰ degree of which 15 cases of laryngeal obstruction, Ⅱ degrees 12 cases of laryngeal obstruction, Ⅲ degree of five cases of laryngeal obstruction, Propofol- fentanyl or Propofol-remifentanil intravenous anesthesia,Endotracheal intubation patients used apnea Records of induction of anesthesia before, the surgery began, during 10min,the end of surgery MAP, HR, SpO2, and records hypoxemia anesthesia induction, endotracheal intubation, as well as activities during the occurrence of vocal cord. Results At each time point MAP,HR,SpO2 was no significant difference（P〉0.05）, Ⅱ and Ⅲ was higher than Ⅰ （P〈0.05） and Ⅲ was higher incidence than Ⅱ in the incidence of hypoxemia and endotracheal intubation （P〈0.05）. There is no Significant difference between Ⅰ and Ⅱ （P〉0.05）, Ⅲ was lower than Ⅰ and Ⅱ incidence of vocal cord aetivities（P〈0.05）. Conclusion Pediatric laryngeal papilloma surgery anesthetic management should be based on the specific circumstances of the patient＇s choice of narcotic drugs and anesthesia,Intravenous anesthesia and apnea in children with laryngeal papilloma excision of the feasibility of a certain.

关 键 词：儿童 喉乳头状瘤 麻醉 呼吸暂停 

分 类 号：R726.1[医药卫生—儿科]