小儿腭裂修补术围拔管期血氧饱和度值变化分析

The Change of SPO2 in children undergoing palatoplasty during Periextubation

目的 观察小儿腭裂手术围拔管期血氧饱和度（ＳＰＯ２）变化，并分析原因。方法 ３０例先天性腭裂患儿，择气管插管静脉复合全麻，记录停静脉麻醉时、拔管即刻、拔管后 ５ ｍｉｎ、１０ ｍｉｎ、２０ ｍｉｎ及 ３０ ｍｉｎ时 ＳＰＯ２值。ＳＰＯ２＜９０％示低氧血症，ＳＰＯ２＜８５％为严重低氧血症。结果 拔管后５ ｍｉｎ有１３例患儿有明显低氧血症，占４３．３３％，其中严重低氧血症 ２例；拔管后 １０ ｍｉｎ有低氧血症 ７例，占 ２３． ３３％；拔管后 ２０ ｍｉｎ、３０ ｍｉｎ仅 ２例和 １例。结论 全麻下腭裂修补术，于拔管后 ３０ ｍｉｎ内易发生低氧血症，尤其 ２０ ｍｉｎ内最为明显，应予以吸 Ｏ２和呼吸管理，避免意外发生。

Objective To observe the change of SPO2 in children undergoing cleft palate repairation during periextubation and to analysis the causes. Methods Thirty children suffered from congenital cleft palate were performed general anesthesia with endotracheal intubation and the SPO2 were monitored in the moment of stopping anesthesia,the time just in the tube pulled, and the minutes of the fifth, tenth,twentieth, and thirtieth after the tube were pulled out. SPO2＜90% were regarded as hypoxemia,SPO2＜85% meant serous hypoxemia. Results Thirteen cases had obvious hypoxemia(accounted for 43. 33% ) and 2 cases had severe hypoxemia in the fifth minute after extubation. Seven cases had hypoxemia(23. 33% ) in the tenth minute after the tube pulled out. There were only 2 cases and I cases with hypoxemia developed at the 20th and the 30th minite after extubation respectively. conclusion Palatoplasty under general anesthesia,hypoxemia may occur within 30 minutes,especially within 20 minutes. The inhalation of oxygen and the care of upper respiratory tract should be emphasized.