纤维支气管镜检查型喉罩及配套异物钳在小儿气道异物取出术中的应用

Application of bronchofiberscopy laryngeal mask coupled with foreign body forceps in the removal of children airway foreign bodies

目的 评价纤维支气管镜（简称纤支镜）检查型喉罩及配套异物钳在小儿气道异物取出术中的应用价值.方法 使用自行设计的纤支镜检查型喉罩和其配套使用的专用异物钳,对2011年1月至2013年10月住院的气管异物92例患儿在快速诱导全身麻醉下实施气道异物取出术.应用纤支镜检查型喉罩通气,记录患儿血压、心率、脉搏氧饱和度以及呼气末二氧化碳的变化.采用SPSS 13.0软件进行统计分析.结果 全部患儿的手术均顺利完成,血流动力学指标稳定,通气效果良好,与麻醉前基础值比较,插喉罩后即刻、喉罩置入后3 min、支气管镜进入声门即刻和拔喉罩后即刻时心率、血压、呼气末二氧化碳分压差异均无统计学意义（P值均＞0.05）,在喉罩置入后脉搏氧饱和度有明显提高（F=3.04,P＜0.05）.结论 纤支镜检查型喉罩及配套异物钳用于小儿气道异物麻醉和手术安全可靠,效果满意,并发症少.

Objective To discuss the value of bronchofiberscopy laryngeal mask airway coupled with foreign body forceps in the removal of children airway foreign bodies.Methods Bronchofiberscopy laryngeal mask airway and its mating foreign body forceps were designed.Ninety-two children with airway foreign bodies were hospitalized from Jan.2011 to Oct.2013 underwent removal surgeries through bronchofiberscopy via laryngeal mask airway coupled with the mating foreign body forceps under fast induction general anesthesia.The fluctuation of the patients＆#39; blood pressure （BP）,heart rate （HR）,saturation of pulse oxygen （SpO2） and pressure of end-tidal carbon dioxide （PetCO2） were recorded.SPSS 13.0 software was used to analyze the data.Results All the operations were successful,and the haemodynamics indexes of the patients were stable with good ventilation.No side effect and complications were found.Compared with the basic value before anesthesia,there was no statistically significant difference in pulse blood pressure PetCO2 between immediately after laryngeal mask,laryngeal mask after 3 minutes,bronchoscope into the glottis instantly,immediately after laryngeal mask.SpO2 increased after laryngeal mask（F =3.04,P 〈 0.05）.Conclusion Bronchofiberscopy laryngeal mask airway coupled with foreign body forceps applied in the removal surgery of children airway foreign body is safe,effective and with less complication.