新生儿食管闭锁合并气道瘘手术麻醉呼吸管理

Anesthesia respiratory management of operation for neonatal esophageal atresia with airway fistula

目的:探讨新生儿食管闭锁合并气道瘘手术麻醉当中的呼吸管理。方法:选择48例新生儿食管闭锁手术的相关麻醉记录,分析小儿患者麻醉不同时期的心率、SpO_2、呼吸频率及麻醉并发症发生状况。结果:48例患者均采用以七氟醚吸入为主的麻醉方式,在结扎食管气道瘘口前保留自主呼吸,在麻醉诱导过程中,患者的心率、呼吸频率等数据指标均保持正常,手术实施到开胸阶段后患者的心率、呼吸频率有明显的升高,但是SpO_2指标正常。结论:在临床上针对新生儿食管闭锁修补手术当中,做好术前准备,从麻醉前期一直到手术完成之后,通过以七氟醚吸入为主的麻醉方式能够有效确保患者自主呼吸管理,可降低手术过程中并发症的发生。

Objective：To explore the anesthesia respiratory management of operation for neonatal esophageal atresia with airway fistula.Methods：The related anesthesia records of 48 children with neonatal esophageal atresia operation were selected,we analyzed the heart rate,SpO2,respiratory rate and the incidence of anesthesia complications at different stages of anesthesia. Resuhs：48 patients received sevoflurane inhalation anesthesia,before ligating the fistula of the esophagotracheal fistula,the patients maintained spontaneous breathing,during the induction of anesthesia,the heart rate and respiratory rate of the patients remained normal,after the thoracotomy stage,the heart rate and respiratory- rate of the patients increased significantly,but the SpO2 index was normahConclusion：In clinical practice,for repair of esophageal atresia in neonates,we should make good preparations before the operation,from the early stage of anaesthesia to the completion of the operation,sevoflurane inhalation based anesthesia can effectively ensure patients＇ autonomous breatbing management,can reduce complications during operation.