支撑喉镜联合Hopkins镜行小儿气管、支气管异物取出术

Suspension laryngoscopy combined with Hopkins telescopy for removing the tracheal or bronchial foreign body in children

目的探讨两种不同手术方式在治疗小儿气管、支气管异物的临床效果,从而达到提高小儿气管、支气管异物取出术的安全性及治疗效果。方法回顾性分析2008年1月～2013年12月来我科收治的60例小儿气管、支气管异物待查患者,手术方法分别采用静脉麻醉高频给氧硬性支气管镜检查取出异物（对照组）或气管内插管静脉全身麻醉支撑喉镜联合Hopkins内镜检查取出异物（观察组）。术中观察记录患儿导入支气管镜次数、SpO2≤85%的时间及手术时间。结果 60例患者中58例发现异物并成功取出。比较两组手术时间、术中导入支气管镜次数,SpO2〈85%的时间,差异均有统计学意义。术中22例患者SpO2≤85%,观察组10例,对照组12例。1例患儿需术中行气管切开术,4例患儿出现并发症。结论气管内插管静脉全身麻醉经支撑喉镜联合Hopkins镜气管支气管异物取出术是一种治疗小儿气管支气管异物的理想、安全、有效的方法,值得在临床推广。

OBJECTIVE To explore the clinical effects of two types surgery on treatment of tracheal or bronchial foreign body in children.METHODS The clinical data of 60 children with tracheal or bronchial foreign body from January 2008 to December 2013 in our hospital were studied retrospectively. All the patients underwent rigid bronchoscopy under intravenous anesthesia with high frequency ventilation（control group） or suspension laryngoscopy combined with Hopkins telescopy under general anesthesia with endotracheal intubation（observation group） for removing the tracheal or bronchial foreign body. The number of the introduction bronchoscope, the time of SpO285% during the operation and operation time were recorded. RESULTS Bronchial foreign body in 58 cases was successfully removed. Operation time, number of the introduction bronchoscope, the time of SpO285% during the operation were statistically significant between the two groups（P〈0.05）. There were 22 children with SpO2 below 85% during the operation. One case needed tracheotomy during operation. There were 4 cases with complications after operation. CONCLUSION Removing bronchial foreign body via suspension laryngoscopy and Hopkins telescopy under general anesthesia with endotracheal intubation is ideal, safe and effective method in children. It is valuable to use widely in clinic.