经气管内插管静脉全身麻醉儿童支气管异物取出  

Removal of Bronchial Foreign Body under General Anesthesia with Endotracheal Intubation in Children

作　　者：雷文斌[1] 文卫平[1] 柴丽萍[1] 祝小林[1] 王章锋[1] 冯霞[2] 蒋爱云[1] 苏振忠[1] 

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院／／耳鼻咽喉科学研究所．广东广州510080 [2]中山大学附属第一医院麻醉科．广东广州510080

出　　处：《中山大学学报（医学科学版）》2012年第1期107-110,共4页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】评估气管内插管静脉全身麻醉下经支气管镜或支撑喉镜联合Hopkins内镜取儿童支气管异物的安全性及效果,以提高儿童支气管异物处理的水平。【方法】回顾性分析45例我院收治的支气管异物待查患儿,于气管内插管静脉全身麻醉下行支气管镜检查或支撑喉镜联合Hopkins内镜检查,取出异物。术中密切监测生命体征并记录手术时间。【结果】行支气管镜检查术15例,支撑喉镜联合Hopkins内镜检查术30例,术中全部病例均经历临时拔出气管插管,共43例发现并成功取出异物,2例未发现异物,全部病例的平均手术时间(8.5±6.0)min,支气管镜组(12.9±6.4)min,支撑喉镜联合Hopkins内(5.8±3.8)min,15例术中曾出现短暂SpO2低于85%,全部病例PETCO2及心率等生命体征平稳。未出现任何并发症。【结论】气管内插管静脉全身麻醉下经支气管镜或支撑喉镜联合Hopkins内镜取出患儿气管支气管异物,手术操作简便,快速,麻醉简单、安全、疗效显著,值得推广。[ Objective ] This study was attempted to assess the safety and facilitation of bronchial foreign body removal under general anesthesia with endotracheal intubation （GA with ET）, and summarized to improve bronchial foreign body treatment level in children. [ Methods ] Retrospective analysis of 45 cases suspicious bronchial foreign body patients of our hospital was carried out. All the patients underwent bronchoscope or suspension laryngoscopy and Hopkins telescopy to remove the bronchial foreign body, under GA with ET. Operative parameters and intraoperative vital signs were closely monitored. [Results] Fifteen cases underwent bronchoscope, 30 cases underwent suspension laryngoscopy and Hopkins telescopy. All the cases were temporarily extubated. Bronchial foreign body was successfully removed in 43 cases, and not found in the other 2 cases. The mean operation time of all the cases, bronchoscope group and Hopkins telescopy group were （8.5± 6.0） min, （12.9 ± 6.4） min, and （5.8 ± 3.8） min, respectively. SpOz was below 85% in 15 cases. Vital signs including PETCO2 and heart rate （HR） were stable in all the cases. There were no complications in the series. [Conclusions ] Bronchial foreign body removal via bronchoscope or suspension laryngoscopy and Hopkins telescopy under GA with ET should be promoted, since it is safe and easy for both anesthesiologists and otorhinolaryngologists to operate, with a remarkable curative effect.

关 键 词：支气管异物 气管内插管静脉全身麻醉 支气管镜检查术 支撑喉镜检查术 Hopkins内镜检查术 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]