控制通气在全麻患儿支气管异物取出术中的应用研究  

Application of Controlled Ventilation in Bronchial Foreign Body Removal in Children with General Anesthesia

作　　者：纪金芬 刘海瑞[2] 陈蒋东 赵敏娟[1] 张国平[1] JI Jin-fen;LIU Hai-rui;CHEN Jiang-dong;ZHAO Min-juan;ZHANG Guo-ping(Department ofAnesthesiology,The Affiliated Zhangjiagang Hospital of Nanjing University of Chinese Medicine,Zhangjiagang,Jiangsu,215600,China;Department of Anesthesiology,The Second Affiliated Hospital ofSoochow University,Suzhou,Jiangsu,215004,China)

机构地区：[1]南京中医药大学附属张家港医院麻醉科,江苏张家港215600 [2]苏州大学附属第二医院麻醉科,江苏苏州215004

出　　处：《现代生物医学进展》2019年第11期2188-2192,共5页Progress in Modern Biomedicine

基　　金：江苏省临床医学科技专项资助项目(BL2012267)

摘　　要：目的:探讨静脉全麻下小儿支气管异物取出术中控制通气的应用效果。方法:选择2014年1月~2018年7月本院收治的支气管异物患儿138例为研究对象,所有患儿均在静脉全麻下行支气管异物取出术,采用随机数字表法将其分为对照组(采用自主呼吸通气,69例)和观察组(采用控制通气,69例),比较两组手术时间、麻醉时间、苏醒时间、置镜首次成功率、置镜时间、置镜难易程度、心率、平均动脉压(MAP)、血氧饱和度(SpO2)及不良反应发生率。结果:观察组手术时间、麻醉时间、苏醒时间均短于对照组(P<0.05);观察组置镜首次成功率高于对照组,置镜难度低于对照组,置镜时间短于对照组(P<0.05);观察组麻醉后心率、MAP水平低于对照组,SpO2水平高于对照组(P<0.05);观察组不良反应发生率均低于对照组(P<0.05)。结论:静脉全麻患儿支气管异物取出术中,采用控制通气的方式效果较好,其具有较强的可控性,且安全性高,是一种较理想的手术麻醉方案。Objective: To explore the application effect of controlled ventilation under intravenous general anesthesia for removal of bronchial foreign bodies in children. Methods: 138 children with bronchial foreign bodies who were admitted to our hospital from January2014 to July 2018 were selected as the subjects,all the children were treated with removal of bronchial foreign bodies under intravenous general anesthesia. They were divided into control group(autonomous breathing ventilation mode, 69 cases) and observation group(controlled ventilation mode, 69 cases) by random number table. The operation time, anesthesia time, waking time, lens placement first success rate, difficult of lens placement, lens placement time, heart rate, mean arterial pressure(MAP), blood oxygen saturation(SpO2) and the incidence of adverse reactions were compared between the two groups. Results: The operation time, anesthesia time and waking time of the observation group were shorter than those of the control group(P<0.05). The lens placement first success rate of the observation group was higher than that of the control group, the difficult of lens placement was lower than that of the control group, and the lens placement time was shorter than that of control group(P<0.05). After anesthesia, the heart rate and MAP level of the observation group were lower than those of the control group, and the SpO2 level was higher than that of the control group(P<0.05). The incidence of adverse reactions of the controlled breathing was lower than that of the control group(P<0.05). Conclusion: The effect of controlled ventilation is better in children undergoing bronchial foreign body extraction under general anesthesia, it has strong controllability and high safety,which is an ideal surgical anesthesia program.

关 键 词：支气管异物取出术 静脉全麻 自主呼吸 控制通气 小儿 

分 类 号：R562.2[医药卫生—呼吸系统]