先天性唇腭裂小儿并气道狭小的临床观察

The complicated tracheal stenosis in children with cheilopalatoschisis

目的 探讨先天性唇腭裂小儿可能并有气道狭小的发生率。方法 选择先天性唇腭裂手术及非唇腭裂手术各 2 0 0例 ,均采用全麻气管内插管麻醉 ,准备标准管、小 1号管和小 2号管三根 ,待肌松监测四个成串刺激显示 T1 消失时进行插管。结果 唇腭裂组插标准管困难的比率明显高于对照组 (P<0 .0 1) ,需改用小 2号管插入的比率高于对照组 (P<0 .0 5 ) ,按体重分小组对比 ,唇腭裂组的达标体重小组与未达标体重小组插标准管困难的比率均高于对照组 (P<0 .0 5 )。结论 先天性唇腭裂小儿 ,无论是正常体重儿还是低体重儿 ,并有气道狭小的发生率都显著高于非唇腭裂小儿。

Objective To explore the occurrence rate of the tracheal stenosis in children with cheilopalatoschisis.Methods Two hundred children with cheilopalatoschisis (test group)and 200 ones without it (control group)were selected,with either group being divided into two sub groups:standard and non standard weight.The intratracheal intubation was taken with three kinds of tubes:standard size,No.1 smaller one,or No.2 smaller one in all pediatric patients when muscle did not respond to T 1 following train of four stimulation.Results The hard intubation rate of standard tube and the required No.2 smaller tube rate were higher in test group than those in control group (P<0.05 or 0.01).The hard intubation rates of standard tube were markedly higher in both sub guoups of test group than those in both sub groups of control group ,respectively (P<0.05).Conclusion The difficult intratracheal intubation should be paid more attention in the pediatric patient with cheilopalatoschisis during anesthesia induction.