新生儿食管闭锁伴食管气管瘘手术期间的呼吸管理

The respiratory management for 15 newborns with tracheo esophageal fistula and esophageal atresia during operation

目的:总结15例新生儿气管食管瘘伴食管闭锁手术期间的呼吸管理。方法:伴有肺部感染的患儿术前抗炎、纠正电解质紊乱1～2天,术前30min肌注阿托品0.1mg。诱导静脉注射芬太尼3ug/kg,维库溴铵0.1mg/kg,丙泊酚3mg/kg气管插管,麻醉维持吸入0.8～1.2%异氟醚,间断给予丙泊酚1mg/kg次。结果:12例患儿术后恢复良好,康复出院;2例肺部感染较重;1例伴有心脏畸形及严重肺部感染死亡。15例患儿术后ICU机械通气1～7天。结论:防治左OLV时低氧血症的发生及发生机理。

Objective To make a research on the respiratory management for 15 newborns with tracheo esophageal fistula and esophageal atresia during operation. Methods Atropine 0.1mg was injected muscular as premedication in all patients. Anesthesia for all cases was induced with fentanyl 3ug/kg. vecurnonium 0.1 mg/kg and propofol 3mg/kg.maintained with 0.8%-1.2% isoflurane inhaled and propofol 1mg/kg intermitartry intravenous injection. One-lung ventilation colvs during the operation was chosen. Results All patients received mechanic ventilation support for 1-7 days postoperatively. 12 cases had a good recovery; 2 cases complicated with serious lung infection; one case combined with heart malformation. Conclusion To discuss the mechanism of hypooxengimia during the one-lung ventilation and how to prevent it happen.