小儿气管异物取出术不同麻醉方法的临床分析  

Clinical analysis of different anesthesia methods for removal of foreign body in trachea in children

作　　者：王国恩[1] 马琪[1] 吕建瑞[1] 李伟[1] 

机构地区：[1]西安交通大学医学院第二附属医院,陕西西安710004

出　　处：《中国医刊》2014年第11期46-47,共2页Chinese Journal of Medicine

摘　　要：目的探讨2种复合麻醉方法对小儿气管异物手术麻醉的效果。方法120例患儿随机分为咪达唑仑-芬太尼-氯胺酮组(M组,n=52),γ-羟基丁酸钠-氯胺酮组(γ-OH组,n=68)。观察麻醉前、置镜后和异物取出后的心率(HR)、血氧饱和度(SPO_2)、术中呛咳、喉及支气管痉挛、异物取出后需气管插管次数及苏醒时间并记录数据。结果麻醉前、置镜后、异物取出后,两组的HR、SPO_2差异无显著性(P>0.05);呛咳、喉及支气管痉挛和气管插管次数M组高于γ-OH组(P<0.05);苏醒时间M组小于γ-OH组(P<0.01)。结论咪达唑仑-芬太尼-氯胺酮复合麻醉术中呛咳、支气管痉挛、气管插管次数比γ-羟基丁酸钠复合麻醉组发生率高,但术后苏醒快,是气管镜下小儿气管异物取除术的一种可供选择的麻醉方法。Objective To compare the safety of different combined anesthesia methods for removal of foreign body in trachea in children, and investigate the efficiency of them. Method 120 children undergoing the removal of foreign body in trachea were divided into midazolam-fentanyl-ketamine group （ M group, n=52 ） and sodium γ-hydroxy-butrate-ketamine group （γ-OH group, n=68 ） . HR, SPO2 before anesthesia, after spectacle insertion and after spectacle dislodgement were observed;the frequencies of bucking, laryngospasm and bronchospasm, and intubation after the removal of foreign body and the time of palinesthesia were also recorded. Result There was no statistical significance on HR and SPO2 between the two groups （P〉0. 05）; the frequencies of bucking, laryngospasm and bronchospasm, and intubation after the removal of foreign body in M group was higher than those in γ-OH group （P〈0. 05）; the time of palinesthesia in M group was shorter than that inγ-OH group （P〈0. 01）. Conclusion The frequencies of bucking, laryngospasm and bronchospasm, and intubation after the removal of foreign body in M group was higher than those inγ-OH group, but palinesthesia more quickly, so the combined anesthesia of midazo-lam-fentanyl-ketamine is a considerable method for the removal of foreign body in trachea in children.

关 键 词：气管异物 复合麻醉 Γ-羟基丁酸钠 

分 类 号：R614[医药卫生—麻醉学]