三通喉罩连续通气下纤维支气管镜在1～6月龄婴儿氧依赖呼吸系统疾病中的应用

Application of fiber bronchoscopy with three-way laryngeal mask airway continuous ventilation in 1-6 month old infants with oxygen-dependent respiratory disease

目的探讨三通喉罩连续通气下行纤维支气管镜术在1-6月龄婴儿氧依赖型呼吸系统疾病中的价值。方法以2010年1月至2011年5月在儿童重症监护病房（PICU）行常规纤维支气管镜术的29例患有氧依赖型呼吸系统疾病的1-6月龄患儿为对照组,以2011年5月至2013年5月在PICU（PICU）行连续通气下纤维支气管镜术的148例患有氧依赖型呼吸系统疾病的1-6月龄患儿为治疗组,比较两组患儿纤维支气管镜术成功率及并发症发生率。结果治疗组纤维支气管镜术成功率89.2%,明显高于对照组的58.6%;喉部水肿率为9.1%,明显低于对照组的35.3%,差异均有统计学意义（P〈0.05）;治疗组术中气管内出血和术后气管插管通气的比例低于对照组,但差异无统计学意义（P均〉0.05）。结论三通喉罩连续通气下纤维支气管镜术用于1~6月龄氧气依赖型呼吸系统疾病患儿,作用明显优于传统纤维支气管镜术。

Objective To discuss the values of fiber bronchoscopy with three-way laryngeal mask airway continuous ventilation in 1-6 month old infants with oxygen-dependent respiratory diseases.Methods From January 2010 to May 2011,29 cases of 1-6 month old infants with oxygen-dependent respiratory diseases who underwent conventional fiber bronchoscope and 148 cases of 1-6 month old infants with oxygen-dependent respiratory diseases who underwent fiber bronchoscopy with threeway laryngeal mask airway continuous ventilation were enrolled in control and treatment groups respectively.The success rate of fiber bronchoscope and the incidence rate of complications were compared between two groups.Results In the treatment group,the success rate of fiber bronchoscope was 89.2% which was significantly higher than 58.6% in the control group and the rate of laryngeal edema was 9.1% which was significantly lower than 35.3% in the control group.The rates of endotracheal intubation ventilation and postoperative hemorrhage were lower than those in the control group,but the difference was not statistical ly significant.Conclusion Fiber bronchoscopy with three-way laryngeal mask airway continuous ventilation is superior to the traditional fiber bronchoscope in 1-6 month old infants with oxygen dependent respiratory system diseases.