小儿支气管异物取出术的麻醉体会

The Understanding of Anesthesia for the Extraction of Infant Bronchial Foreign Body

目的 探讨适合小儿支气管异物取出术的麻醉及用药方式。方法 对 32例小儿支气管异物取出术的麻醉用药方法进行分析。按用药方式分组比较麻醉效果 ,并比较高频喷射通气及侧管供氧的通气效果。结果 全部病例呼吸变化无明显差异 (P >0 0 5 )。术中各阶段脉搏变化大 :麻醉后较入室麻醉前脉搏明显增快 (P <0 0 5 ) ;置镜时单纯氯胺酮组较复合组明显增快 (P <0 0 5 )。置镜时SPaO2 明显低于麻醉后 (P<0 0 5 )和取出异物后 ,高频喷射通气组SPaO2 明显高于侧管供氧。结论 氯胺酮复合r -羟基丁酸钠麻醉 ,辅助高频喷射通气供氧对小儿支气管异物取出术是安全有效的方法。

Objective To discuss the suitable anesthetic mode for infant bronchial foreign body. Methods To summary the anesthetic mode of infant bronchial foreign body of 32 cases (ASAⅡ～Ⅲ) in nearly 20 years retrospectively. To compare the anesthetic result of different medication and compare ventilation effect of high frequency jet ventilation with sideway-duct ventilation. Results There was no significant difference in the respiratory change for all cases (P>0.05). There were significant changes in pulse during the operation: the pulse was more faster in post-anesthesia than pre- anesthesia (P<0.05), and more faster in only ketamine group than compounding group (P<0.05). The SpaO 2 was obviously lower in putting laryngoscope than post-anesthesia and post-extracting foreign body (P<0.05), and higher significantly in high frequency jet ventilation than sideway-duct ventilation mode. Conclusion Ketamine compounding r-OH anesthesia, assisting with high frequency jet ventilation is a safe and effective method for the extraction of infant bronchial foreign body.