肌松药对小儿气管异物取出术麻醉中血气改变的影响  

The Effects on Arterial Blood Gas Changes of Anesthesia for Tracheal Foreign Body Removal with Muscle Relaxants

作　　者：王向东[1] 张少卿[1] 周玉梅[1] 

机构地区：[1]广东省东莞市妇幼保健院,广东东莞523000

出　　处：《深圳中西医结合杂志》2015年第7期6-8,199,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:比较肌松药应用于小儿气管异物取出术对血气改变的影响。方法:选择行支气管镜异物取出术麻醉的患儿60例,随机分为应用肌松药组(I组)与未应用肌松药组(Ⅱ组),每组各30例,对两组患儿入室时(T1)、异物取出时(T2)、出室时(T3)动脉血气中p H值,二氧化碳分压(PCO2),血氧分压(PO2),碱剩余(BE)等指标进行比较,并记录两组手术时间,出室时间;术中发生呛咳、呼吸暂停、支气管痉挛的次数;术中出现Sp O2低于90%并持续无改善,需终止手术的例数。结果:Ⅰ组手术时间明显低于Ⅱ组,差异有统计学意义(P<0.05),出现呛咳、支气管痉挛、Sp O2低于Ⅱ组,差异有统计学意义(P<0.05)。Ⅰ组p H值、BE均明显高于Ⅱ组,PCO2低于Ⅱ组,差异有统计学意义(P<0.05),PO2改变无统计学意义(P>0.05)。结论:在小儿气管异物取出术中应用肌松药可明显改善患儿因二氧化碳蓄积引发的呼吸性酸中毒及缺氧所致的代谢性酸中毒程度,更利于术中气道的管理。Objective To observe the effects on changes in arterial blood gas of anesthesia for tracheal foreign body removal with muscle relaxant. Methods 60 cases of anesthesia for tracheal foreign body removal in children were randomly divided into muscle relaxants group（group I） and control group（Group II）, 30 cases in each group. The p H, blood PCO2, PO2, BE and other indicators were compared during in the room（T1）, foreign body removal（T2） and out the room（T3）. Results Group I operation time was obviously lower than that of group II（P 〈 0.05）, and appear cough, bronchial spasm, below 90 % Sp O2 were lower than those in group II（P 〈 0.05）. Group I’s p H, BE were signifi cantly higher than group II, while PCO2 was lower than group II（P〈0.05）, and the change of PO2 had no statistical signifi cance（P 〉 0.05） Conclusions The muscle relaxants on anesthesia for tracheal foreign body removal can obviously improve the respiratory acidosis with the accumulation of carbon dioxide and metabolic acidosis with hypoxia, more favorable to intraoperative airway management.

关 键 词：气管异物 血气分析 肌松药 麻醉 

分 类 号：R614[医药卫生—麻醉学]