超声雾化麻醉下行呼吸道异物取出术的探讨

Study on the removal of bronchial foreign bodies in ultrasonic atomization anesthesia

目的 :探讨省时、经济、安全的呼吸道异物取出术的麻醉方法。方法 :呼吸道异物 2 0 0例术前 30min肌注阿托品 0 .0 1mg kg。雾化器雾化瓶内置入 1%利多卡因 2 0ml,让患儿平静呼吸 ,雾化喷嘴距口、鼻 2cm ,平静呼吸 10～ 15min后进行手术。结果 :176例异物顺利取出 ,术中并发喉及气管痉挛 16例 ,占 8% ,气管内出血 5例 ,占 2 .5 % ,气胸及皮下气肿 2例 ,占 1% ,异物变位窒息 1例 ,占 0 .5 % ,喉水肿 12例 ,占 6 % ,呼吸停止2例 ,占 1%。无死亡病例。结论 :超声雾化吸入麻醉可将表面麻醉剂吸入咽喉气管、支气管 ,避免器械刺激引起的迷走神经反射 。

Objective:To explore a proper anesthesia method for removal bronchial foreign bodies in children. Method:200 cases with bronchial foreign bodies were injectied atropin(0.01mg/kg)thirty minutes befor the operation,then took atomization inhale of 1% lidocaine 20ml about 10～15 minutes.Results:176 cases of bronchial foreign bodies were taken out easily. During the operation,16 cases(8%)had a larynx and trachea spasm, 5 cases(2.5%)had bleeding in trachea,2 cases(1%)had pneumothorax and subcutaneous emphysema,1 case(0.5%) had a suffocation because of the change of place of the foreign body,12 cases(6%) had throat edema,2 cases(1%)stopped respiration,but no one died . Conclusion:The inhalation anesthesia of ultrasonic atomization can inhalat topical anesthesia into larynx,trachea and bronchic.This method can avoid vagus nerve reflex by apparatus stimulus and reduce spasm of throat and trachea.Compared with general aneshesia,the inhalation anesthesia of ultrasonic atomization is more economical,safty and effective.