肌松剂配合面罩加压呼吸在小儿纤支镜气管异物取出术中的应用

目的：探讨肌松剂配合面罩加压呼吸法在小儿纤支镜气管异物取出术中的应用效果。方法：选取本院行气管异物患儿78例，随机分为观察组与对照组，两组均在全身麻醉下行纤支镜气管异物取出术；观察组麻醉诱导成功后，在肌松剂配合面罩加压呼吸下行纤支镜气管异物取出术，对照组在高频通气法下行纤支镜气管异物取出术，对比两组术中情况，并观察两组麻醉前5min时（T0）、置入胃管时（T1）、手术开始时（T2）、钳取异物时（T3）和拨除气管导管时（T4）生命体症变化及术后并发症发生情况。结果：两组均顺利取出气管异物，观察组手术总用时、麻醉时间、苏醒时间均明显低于对照组，差异具有统计学意义（P〈0．05）；纤支镜在气管内一次持续停留时间高于对照组，差异具有统计学意义（P〈0．05）；观察组手术各时间点收缩压（SBP）、舒张压（DBP）、心率（HR）波动低于对照组，在T2、T3时SBP、DBP、HR均低于对照组，SpO2高于对照组，差异有统计学意义（P〈0．05）；观察组手术并发症发生率低于对照组，差异有统计学意义（P〈0．05）。结论：肌松剂配合面罩加压呼吸可显著降低支气管异物患儿喉部肌肉及支气管痉挛，稳定患儿生命本征，对提高手术、麻醉的安全性作用明显。

Application of nondepolarizing agent combined with breathing mask pressure in removing tracheobronchial foreign bodies in children by pediatric bronchoscopy

Objective： To investigate the application of nondepolarizing agent combining with mask pressure breathing in removing the tracheobronchial foreign bodies in children by pediatric bronchoscopy. Methods： A total of 78 children with airway foreign body admitted in our hospital were randomly divided into observation group and control group, both groups were treated with pediatric bronchoscopy under general anesthesia. After the success of anesthesia induction, breathing bronchoscopy nondepolarizing agent was applied with the pressure mask in the observation group, the control group was treated with high frequency ventilation. Compared intraoperative situation between the two groups, and observed vital signs and status at 5 time points including anesthesia induction （T0）, 5 min before the time of gastric tube placing （T1）, at the beginning of operation （T2）, clamping bodies （T3） and removing endotracheal tube （T4）, and observed the vital sign changes and postoperative complications. Results： Procedures in both groups were successful, total operation time, anesthesia time, waking time in observation group were significantly less than that in control group （P〈0.05）, continuous endotracheal residence time of bronchosco py in observation group is significantly higher than that in the control group （P〈0.05）. Observation group showed significant-ly more fluctuations of SBP, DBP and HR than that of control group at each time point （P〈0.05）, and lower SBP, DBP, HR levels at T2 and T3 and higher SpO2 level compared with control group （P〈0.05） surgical complication rate was lower in observation group than that in control group （P〈0.05）. Oonclusion： Nondepolarizing agent combined with mask pressure can sig nificantly reduce respiratory laryngeal muscles in bronchial operation of removing foreign bodies in children, it can stabilize the intrinsic life, improve safety of surgery and anesthesia effect is remarkably.