γ-羟基丁酸钠复合丙泊酚在小儿气管异物取出术的应用

Application of Propofol Combined with (γ-OH)Sodium Hvdroxvbutvrate for the Bronchosecope of Children

目的:观察和比较γ-羟基丁酸钠复合丙泊酚用于小儿支气管镜检查及气管异物取出术的效果。方法:选择住院行支气管镜检查及异物取出术患儿60例,随机分为γ-羟基丁酸钠一氯胺酮麻醉组(K组)和γ-羟基丁酸钠一丙泊酚麻醉组(P组),每组各30例。每组均缓慢静注γ-羟基丁酚钠(80～100) mg/kg,予面罩及氧(5～10) min后,K组缓慢静注氯胺酮2mg/kg, 置镜后视情况按(1～2) mg/kg追加;P组缓慢静注丙泊酚2mg/kg,置镜后视情况按(1～2)mg/kg追加。观察麻醉后术前、置镜时、术中、术后BP、HR、SPO2、RR、有无屏气、呛咳、术后喉水肿、舌后坠等情况。结果:两组患儿置镜前置镜后,MAP、 HR数值P组均显著低于K组(P<0.05);P组置镜后HR、MAP均显著下降(P<0.05),而K组HR不明显,MAP显著上升(P<0.05);P组置镜后,RR较入室时显著下降(P<0.05),且明显低于K组(P<0.05);两组SPO2无差异。K组置镜时屏气、术中屏气,术后舌后坠、喉水肿、苏醒期屏气等并发症明显高于P组(P<0.05),苏醒时间较P组明显延迟(P<0.05)。结论:γ-羟基丁酸钠一丙泊酚用于小儿支气管镜检查及气管异物取出术优于γ-羟基丁酸钠-氯胺酮麻醉效果。

Objective： To observe and compare the anesthesia effect of propofol combined with （γ-OH）sodium hydroxybutyrate used in the bronchosecopes and the removal of children＇s intratracheal foreign body.Methods： Choosing 60 patients in hospital to be done the operation of bronchosecopes and the removal of children＇s intratracheal foreign body,the patients of selective operation were randomized into K group（n=30） related to （γ-OH）sodium hydroxybutyrate-ketamine and P group（n=30）related to （γ-OH）sodium hydroxybutyrate-propofol.The patients were respectively injected （γ-OH）sodium hydroxybutyrate slowly given in a dose of 80～100mg/kg,and then offer oxygen （5～10） minutes with a face mask.Afterthat the patients in group K were injected ketamine slowly in the dose of 2mg /kg,and （1～2）mg/mg after laying the bronchosecope according as case.The patients in group P were injected propofol slowly in the dose of 2mg/kg,add （1～2）mg/kg according as case.Observing the patients＇ BP,HR,SPO2,RR and if or not holding breath,bucking,postoperation laryngeal edema,glossocoma at the different periods： preoperation,laying the bronchosecope,during the operation and after the operation.Results： To compare the two groups,the MAP,HR of group P are lower obviously than group K before and after laying the bronchosecope（P〈0.05 ）.The HR,MAP of groug P descend significantly after laying bronchosecope（P〈0.05 ）,while the HR fluctuate little but MAP ascend significantly in the group K （P〈0.05）.After laying bronchosecope the RR descend significantly than that when patiens entered operation room （P〈0.05）,and also lower than that of group K（P〈0.05.The SPO2 in the two groups have no difference.The complications as holding breath,postoperative glossocoma,laryngeal edema,holding brenth during reviving time,in the group K happened at a high rate than the group P （P〈0.05）,the awaking time is also longer in the former （P〈0.05 ）.Conclusion： The anesthesia effect of （γ-OH）sodium hydroxybutyrate-propofol is superiorto that of （γ-OH）sodium hydroxybutyrate-ketamine in the removal of children＇s intratracheal foreign body.