上呼吸道感染患儿盐酸戊乙奎醚全身麻醉对呼吸系统的影响

Impact of systemic anesthesia with hydrochloride penehyclidine on respiratory system of children with upper respiratory tract infections

目的探讨上呼吸道感染(URI)患儿全身麻醉前应用盐酸戊乙奎醚对患儿呼吸系统的影响,以减少患儿围术期上呼吸道并发症发生率。方法选取医院2011年1月-2012年1月收治的40例上呼吸道感染行急诊上肢骨折切开复位内固定术的患儿为研究对象,将其随机分成观察组和对照组,每组20例,对照组术前30min肌内注射阿托品;观察组术前30min肌内注射盐酸戊乙奎醚,对患儿进行常规麻醉后,观察患儿心率(HR)、血氧饱和度(SpO2)的变化和不良反应发生率,数据采用SPSS17.0软件进行统计分析。结果两组患儿全身麻醉后行上肢或下肢骨折切开复位内固定术,均出现了支气管痉挛、喉痉挛、术中吸痰≥2次及SpO2<90%不良反应,观察组患儿的不良反应发生率明显低于对照组,其中术中吸痰>2次的发生率观察组为15.0%,对照组为50.0%;观察组患儿各年龄段的术中平均心率较对照组患儿明显降低,差异有统计学意义(P<0.05)。结论对上呼吸感染患儿全身麻醉前给予盐酸戊乙奎醚,可有效减少患儿术中、术后不良反应发生率,在临床上值得推广应用。

OBJECTIVE To explore the influence of use of penehyclidine hydrochloride before systemic anesthesia on respiratory systems of children with upper respiratory tract infections so as to reduce incidence of perioperative respiratory complications. METHODS A total of 40 children, who underwent the emergency upper limb fractures with open reduction and internal fixation in the hospital from Jan 2011 to Jan 2012, were enrolled in the study and randomly divided into the observation group and the control group, with 20 cases in each, then the control group was treated with intramuscular injection of atropine 30 rain before the surgery, while the observation group was given the intramuscular injection of penehyclidine hydrochloride 30 rain before the surgery, the changes of heart rate （HR） and oxygen saturation （SpO2） and the incidence of adverse reactions were observed after the conventional anesthesia, and the data were statistically analyzed with the use of SPSS17.0 software. RESULTS Among all the subjects who underwent the upper or lower extremity fractures with open reduction and internal fixation after the systemic anesthesia, the adverse reactions such as bronchospasm, laryngospasm , intraoperative suctioning more then 2 times, and SpO2 less than 900//00 occurred the incidence of the adverse reactions of the observation group was significantly lower than that of the control group, the incidence of the intraoperative suctioning more than 2 times was 15.0 in the observation group, 50.0 in the control group. As compared with the control group, the intraoperative mean HR of the observation group was significantly reduced, with statistical significance （P 0. 05）. CONCLUSION The application of penehyclidine hydrochloride before the systemic anesthesia may effectively reduce the incidence of postoperative adverse reactions in the children with upper respiratory tract infections, which is worthy to be promoted in the hospital.