术前基础麻醉下小儿插胃管术的效果分析  

The Effect Analysis of Preoperative Basal Anesthesia in Pediatric Gastric Intubation

作　　者：吴艳媛[1] 吴艳珠[1] 

机构地区：[1]广东省江门市中心医院手术室,广东江门529000

出　　处：《临床医学工程》2012年第4期608-610,共3页Clinical Medicine & Engineering

摘　　要：目的探讨进行手术小儿术前需插胃管使用基础麻醉下插胃管方法、效果与不良反应。方法随机选择需插胃管手术患儿100例,随机分为实验组与对照组各50例,年龄为3～6岁,体重12～21kg,ASAⅡ～Ⅲ。实验组病例术前采用基麻,使用药品是鲁米那每公斤0.5mg,力月西每公斤0.05mg,氯胺酮每公斤0.7mg,全部药品静脉注入,患儿安静入睡后,使用胃管型号是8号,胃管加管芯,从鼻腔后鼻道贴咽后壁缓慢往下送,当成功插入胃管后,抽出带有黄色液体即可确定胃管是插入胃腔,按一定长度固定胃管接上负压引流瓶。对照组患儿是采用常规护理学上插胃管术清醒状态插胃管,由于患儿恐惧不合作,反复多次插胃管术较多。结果实验组患儿术前插胃管46例均获成功,而对照组是31例。实验组插胃管过程发生恶心7例,呕吐6例。而对照组插胃管过程发生恶心38例,呕吐36例。实验组插胃管过程胃内容物反流2例,误吸无发生,而对照组插胃管过程发生胃内容物反流13例,误吸呼吸道8例,氧饱和度下上波动,呼吸抑制2例。实验组插胃管过程血流动力学平稳,无血压升高和心跳加快现象,而对照组插胃管过程出现心跳加快血压升高现象。所以术前插胃管术实验组患儿与对照组比较具有显著性差异(P<0.01)。结论患儿术前插胃术采用基麻,效果良好,成功率高,安全,并发症及不良反应少,值得临床上推广应用。Objective To investigate methods,effects and adverse reactions of preoperative basal anesthesia in pediatric inserting gastric tube.Methods 100 children（3 ~ 6 years old,weighing 12 ~ 21 kg,ASA Ⅱ ~Ⅲ） with gastric tube surgical were randomly divided into experimental group and control group.The experimental group received the basal anaesthesia with luminal 0.5 mg/kg,midazolam 0.05 mg/kg and ketamine 0.7 mg/kg by intravenous injection.The stomach tubes（No.8） and tube cores were put down along with posterior nasal meatus and posterior pharyngeal wall after children fall into sleep.When yellow liquid was pulled out,the stomach tubes were fixed with a certain length and the negative pressure drainage bottle was linked up.The control group received the routine insertion of stomach tube.Results The preoperative insertion of stomach tube of 46 cases in the experimental group were successful,while 31 cases in the control group were successful.The cases of nausea and vomit were 7 and 6 in the experimental group,and 38 and 36 in the control group.2 cases of gastric contents backstreaming and no case of aspiration were found in the experimental group,while 13 cases of gastric contents backstreaming,8 cases of aspiration and 2 cases of respiratory depression were found in the control group.The haemodynamics was stable,no case occured with blood pressure elevation or palpitation acceleration,while blood pressure elevation and palpitation acceleration occurred in the control group.The difference between two group had statistical significance（P〈0.01）.Conclusions The preoperative basal anaesthesia of stomach tube insertion has the advantages of good effect,high success rate,safety,fewer complications and adverse reactions,which is worthy of clinical application.

关 键 词：术前 基础麻醉 小儿 插胃管术 静脉注射 

分 类 号：R473.72[医药卫生—护理学]