喉罩全身麻醉下小儿气管镜检查的气道管理分析  

Analysis of airway management in children with bronchoscopy under general anesthesia of larynx mask

作　　者：周力 陈玲玲[1] 张锡凤[1] 王建设[1] 刘璐 蒋文旭 ZHOU Li;CHEN Lingling;ZHANG Xifeng;WANG Jianshe;LIU Lu;JIANG Wenxu(Department of Anesthesiology,Children′s Hospital of Nanjing Medical University,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京医科大学附属儿童医院麻醉科,南京210008

出　　处：《重庆医学》2018年第32期4171-4173,共3页Chongqing medicine

摘　　要：目的探讨喉罩全身麻醉(简称全麻)控制通气用于小儿纤维支气管镜(FB)检查中的效果及安全性。方法选择2013年1月至2017年1月于该院行无痛FB检查的患儿180例,根据随机数字表法分为观察组和对照组各90例。对照组检查期间保留患儿自主呼吸,必要时辅助通气;观察组采用喉罩联合T型密封接头控制通气。比较两组患儿检查、苏醒时间及检查中断次数和瑞芬太尼用量,患儿不同时间点的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2),以及围检查期患儿不良反应及内镜医师的满意度。结果观察组检查时间和检查中断次数均低于对照组(P<0.05),瑞芬太尼用量高于对照组(P<0.05)。检查开始即刻、5min时观察组患儿HR、MAP低于对照组(P<0.05),SpO_2高于对照组(P<0.05)。观察组患儿不良反应发生率低于对照组(P<0.05),医师满意度优于对照组(P<0.05)。结论喉罩控制通气在小儿全麻下行FB检查中效果优于自主呼吸。Objective To explore the efficacy and safety of laryngeal mask airway anesthesia in children undergoing fiberoptic bronchoscopy(FB).Methods A total of 180 children underwent painless FB in hospital from January 2013 to January 2017 were selected and divided into the observation group and the control group with 90 cases in each group.The children were given spontaneous breathing and necessary ventilation in the control group,while the observation group was treated with laryngeal mask airway and T type sealing join.The examination time,the recovery time,the number of interruptions and the dose of remifentanil were compared,the heart rate(HR),mean arterial pressure(MAP)and pulse oximetry(SpO 2)at different time points,the adverse reactions of children in the peri-inspection period and the satisfaction of endoscopists were recorded.Results Compared with the control group,the time of examination and the number of interruptions in the observation group were lower(P<0.05),the dose of remifentanil was higher(P<0.05).HR and MAP in the observation group were lower at begining and 5 min in the examination,SpO 2 was higher(P<0.05).The incidence of adverse reactions in the observation group was lower(P<0.05),the satisfaction rate of the doctors was better(P<0.05).Conclusion Laryngeal mask controlled ventilation is superior to spontaneous breathing in FB under general anesthesia in children.

关 键 词：纤维支气管镜 喉罩 控制通气 小儿 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]