沙丁胺醇预先吸入给药对肺炎支原体肺炎患儿纤维支气管镜灌洗术中气道不良反应的影响

Effects of pre-inhaled salbutamol on adverse airway reactions during bronchofiberscopic lavage in children with Mycoplasma pneumoniae pneumonia

目的探讨沙丁胺醇预先吸入给药对肺炎支原体肺炎患儿纤维支气管镜(简称“纤支镜”)灌洗术中气道不良反应的影响。方法选择该院100例择期行纤支镜灌洗治疗的肺炎支原体肺炎患儿,按照随机数字表法分为对照组和处理组,每组50例。对照组患儿不做处理;处理组患儿于术前5 min吸入沙丁胺醇气雾剂2揿(约200μg)。所有患儿进入手术室后予右美托咪定、舒芬太尼、丙泊酚快速静脉诱导,而后以丙泊酚持续静脉泵注。术中观察患儿生命体征及不良反应,记录丙泊酚用量、舒芬太尼用量、右美托咪定用量、术中最低血氧饱和度、呛咳发生次数、纤支镜灌洗术暂停次数、手术时间、麻醉复苏时间。结果两组患儿性别、年龄、体重差异无统计学意义(P>0.05)。处理组的丙泊酚使用量中位数为4.00 mg/kg,低于对照组的4.26 mg/kg(P<0.05),差异有统计学意义(P<0.05);呛咳次数大于或等于2次的百分率为36%,低于对照组的96%,差异有统计学意义(P<0.05);灌洗术暂停次数大于或等于2次的百分率为12%,低于对照组的40%,差异有统计学意义(P<0.05)。处理组手术时间及复苏时间均明显短于对照组,差异有统计学意义(P<0.05)。结论术前预先吸入沙丁胺醇预可降低肺炎支原体肺炎患儿行纤支镜灌洗术中呛咳发生率,减少低氧血症的发生,术中生命体征更加平稳,术后恢复更快,检查过程更加顺畅、安全。

Objective To investigate the effect of salbutamol pre-inhalation administration on adverse airway reactions during fibrobronchoscope lavage in children with Mycoplasma pneumoniae pneumonia.Methods A total of 100 children with Mycoplasma pneumoniae pneumonia in this hospital who were performed bronchofiberscopic lavage were selected as research subjects.They were divided into the study group and the control group according to the random number method,with 50 cases in each group.The children in the study group were given 2 sprays of salbutamol aerosol(about 200μg)at the time of 5 min before surgery.The control group was not treated.After entering the operating room,all the children were given dexmedetomidine,sufentanil and propofol for rapid intravenous induction,and propofol was continuously pumped intravenously during the operation.Intraoperative vital signs and adverse reactions were observed during the operation,and the total amount of propofol,sufentanil and dexmedetomidine,the intraoperative minimum oxygen saturation,the frequency of coughing,the operation suspension times,the operative time,and the time of anesthesia recovery were recorded.Results There was no significant difference between the two groups in sex,age and weight(P>0.05).The median amount of propofol used in the study group was 4.00 mg/kg,which was lower than 4.26 mg/kg of the control group(P<0.05).The percentage of coughing times≥2 was 36%,which was lower than 96%of the control group;the percentage of operation suspension times≥2 was 12%,which was lower than 40%of the control group(P<0.05),the differences were statistically significant(P<0.05).The operative time and resuscitation time in the study group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).Conclusion Pre-inhalation of salbutamol aerosol before surgery can reduce the incidence of coughing during bronchofiberscopic lavage in children with Mycoplasma pneumoniae pneumonia,reduce the occurrence of hypoxemia,make the intraoperative vital signs more stable,recover faster,and make the examination process fluent and safe,which is worthy of clinical application.