国际麻醉学与复苏杂志   2014, Issue (11): 4-4
    
小儿气管异物取出术三种麻醉方法的比较
蔡英敏, 薛荣亮, 刘鸿涛, 镇路明, 白洁, 张勇, 白丽萍, 肖小玲1()
1.西安交通大学第二附属医院
Comparison of three anesthesia methods to operation about pediatric airway foreign bodies
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摘要:

摘要:目的:比较三种麻醉方法在小儿气管异物取出术中的特点。方法:300例小儿支气管异物患儿随机分为A(氯胺酮+杜冷丁+咪唑安定+右美托嘧啶)组、B(氯胺酮+芬太尼+咪唑安定+顺式阿曲库铵)组、C(七氟醚+丙泊酚+瑞芬太尼+司可林)组 三组。 记录置入硬质支气管镜所用时间,询问术者置入支气管镜的难易程度,记录因体动或低氧饱和度而使手术暂停的次数。麻醉过程中严密监测SaO2,心率;记录入室(T0),置镜时(T1),术毕(T2),清醒(T3)时的心率,SaO2值,术毕测血气,记录手术时间和苏醒时间。结果:A组患儿术中心率相对平稳,苏醒时间最长,术中有屏气现象,无二氧化碳蓄积现象,与B、C组比较,差异有统计学意义;B组患儿苏醒时间比A组时间短,心率较快,术中无屏气现象,有二氧化碳蓄积现象,与A、C组比较,差异有统计学意义;C组患儿苏醒时间最短,心率相对平稳,术中无屏气现象,有二氧化碳蓄积现象,与A、C组比较,差异有统计学意义。三组缺氧患儿例数的差异无统计学意义。结论:三种麻醉方法各有特点,应根据患儿的病情及术者的熟练程度选择应用。

关键词: 关键词:气管异物,麻醉,控制呼吸,自主呼吸
Abstract:

Abstract: Objective: Comparison of three anesthesia methods to operation about pediatric airway foreign bodies. Methods: 300 patients suffered from foreign body in bronchus were divided into group A(Ketamine+Dolantin+Midazolam+Dexmedetomidine)、group B(Ketamine+Fentanyl+Midazolam+Cisatracurium)、Group C(Sevoflurane+Propofol+Remifentanil+Scoline).Recording the time of placing the stereoplasm bronchoscope, Asking the complexity of operation, recording the times of suspended operation because of moving or lower SaO2; Monitoring heart rate,SaO2 during the anesthesia; Recording the heart rate,SaO2 at the time of into the room(T0)、 placing the bronchoscope(T1) 、 finishing the operation(T2) and waking(T3); Recording the time of operation and waking. Result: The heart rate of group A were stable, the time of waking was longest, there was phenomenon od holding breath, there was not carbon dioxide retention, compared with group A and B,the difference was statistically significant; The waking time of group B was longer than group A , heart rate was faster, there was not phenomenon of holding breath and there was carbon dioxide retention, compared with group A and C, the difference was statistically significant; The waking time of group C was shortest, heart rate was relative stable, there was not phenomenon of holding breath and there was carbon dioxide retention,compared with group A and C, the difference was statistically significant.The difference of cases of anoxia was not statistically significant among three groups. Conclusion: There were features of three kins of anesthesia methods themselves , the choice should be according to the situation of patients and the proficiency of operation.

Key words: Key words: foreign body; anesthesia; breathe control; autonomous respiration