小儿气管异物取出68例术中脉搏血氧饱和度分析

本院应用ＯＨＭＥＤＡ3700无创伤脉搏血氧饱和度仪,对气管异物68例取出术中小儿行脉搏血氧饱和度(ＳｐＯ2）监测,报告如下:1　资料与方法1.1　一般资料　患儿68例,男44例,女24例,年龄5月～9岁,体重66～26ｋｇ。气管异物有花生米、豆类、瓜子等。麻醉前用药苯巴比妥钠2～4ｍｇ·ｋｇ-1、阿托品20μｇ·ｋｇ-1。1．2　麻醉方法　γ羟基丁酸钠50～100ｍｇ·ｋｇ-1静脉推注,入睡后予以05%丁卡因、1%利多卡因咽喉、气管内表面麻醉,在支撑喉镜下行支气管镜检查取异物,术中视患儿情况辅用氯胺酮2～4ｍｇ·ｋｇ-1静脉推注,术中常规经支气管镜吸氧5～…     

支气管镜下小儿气道异物取出术中2种肌松药疗效观察

目的观察罗库溴铵和维库溴铵用于支气管镜下小儿气道异物取出术的肌松效果。方法将气管、支气管异物患儿120例随机分为A1组、A2组、W1组和W2组,每组30例。所有患儿常规麻醉后,各组静脉注射相应剂量的肌松药（A1组注射罗库溴铵0.075mg/kg,A2组注射罗库溴铵0.15mg/kg,W1组注射维库溴铵0.05mg/kg,W2组注射维库溴铵0.1mg/kg）。术后比较各组手术时间及苏醒时间。结果各组手术时间比较差异无统计学意义（P〉0.05）。A1组苏醒时间最短为（27.3±6.7）min,其次为A2组、W1组和W2组,差异均有统计学意义（P〈0.05）。结论罗库溴铵用于小儿气管支气管异物取出术起效快,安全性高,是一种较好的肌松药。     

喉麻喷雾管在小儿气道异物取出术的应用

2000-2005年我院应用喉麻喷雾管表麻复合全身麻醉下行小儿气管内异物取出术，取得良好效果，现报道如下： 1资料与方法 1．1 一般资料：本组支气管异物患儿30例，其中男20例，女10例，年龄8／12-10岁，体重6-30kg，异物位于声门下3例，气管内21例，气管分叉处3例，支气管内2例，随机分为表麻复合全身麻醉组和全身麻醉组各15例。     

小儿气管异物取出术麻醉探讨

目的：探讨小儿气管异物取出麻醉方法的选择。方法：138例分成两组，麻醉组8例，非麻醉组130例，对患儿术中的血氧饱和度(SPO2)、心率进行监测。结果：两组比较：术中患儿SPO2、心率变化较大，非麻醉组更利于术中患者SPO2、心率的稳定。结论：4、儿气管异物取出，不用麻醉也能顺利进行手术，但术中应加强监测，用以提高手术的安全性。     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

目的观察七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果。方法选择符合美国麻醉学会制定的Ⅰ-Ⅱ级标准、年龄1—4岁、行气管异物取出术小儿60例,随机数字表法分为七氟醚组和氯胺酮组,每组30例。七氟醚组采用吸入七氟醚诱导麻醉,术中维持药物选用丙泊酚1．5mg／（kg·h）微泵持续注入。间断吸入七氟醚;氯胺酮组静脉注射咪达唑仑0．1mg／kg和氯胺酮1．5mg／kg诱导麻醉,术中麻醉深度不足时分次静脉注射氯胺酮1．5mg／kg至麻醉满意。记录诱导前（T0）、麻醉诱导后术前1min（T2）、插入支气管镜时（T2）、拔支气管镜时（T3）、清醒时（T4）血压、心率及血氧饱和度。记录手术时间、苏醒时间和术中医生满意度,观察术中和术后患儿是否有支气管痉挛、呕吐、呼吸道梗阻、舌后坠等并发症。结果2组患儿T2时收缩压、心率较T0时明显升高。七氟醚组患儿T1时收缩压、心率较T0时明显降低;2组患儿血氧饱和度T1-T4各时段均较T0时明显升高;七氟醚组患儿苏醒时间显著快于氯胺酮组;七氟醚组患儿医生满意度较氯胺酮组高;术后氯胺酮组患儿舌后坠发生率明显高于七氟醚组,差异有统计学意义（P〈0．05）。2组患儿T0～T4各时段舒张压、血氧饱和度差异均无统计学意义（P〉0．05）。结论七氟醚复合丙泊酚在小儿气道异物取出术中能提供良好的手术条件,术中麻醉平稳,术后患儿苏醒快且苏醒质量较高。     

异丙酚用于小儿气管异物取出术的临床观察

小儿气管异物是小儿急症之一,手术时间短,为此需寻求一种具有诱导起效快、苏醒快、插入喉镜条件满意及血流动力学稳定等优点的麻醉剂.现将我院在小儿气管异物取出术中应用异丙酚的体会报道如下:     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

婴幼儿支气管异物取出术的麻醉体会

支气管异物取出术是常见的婴幼儿急诊手术，风险极大。我院自2001年1月～2003年3月对82例患儿成功施行了支气管内异物取出术。现将麻醉体会报告如下：     

氯胺酮双异丙酚复合麻醉用于小儿气道食道异物取出术

目的观察氯胺酮双异丙酚复合用于气管食道异物取出术麻醉的效果。方法氯胺酮静脉1mg/kg或5mg/kg肌肉注射后,静脉双异丙酚诱导量1mg/(kg·min),2min改用0.5mg/(kg·min)维持量,手术结束停止注药。结果患儿生命体征平稳,术中安全,麻醉满意。结论氯胺酮一双异丙酚复合静脉麻醉在小儿食道、气道异物取出术中应用安全可靠、效果满意。     

儿童支气管镜气道异物取出术围术期呼吸系统严重并发症的危险因素分析

目的　探讨支气管镜气道异物取出术患儿围术期呼吸系统严重并发症的危险因素。方法　选择2019年6月至2021年6月徐州市儿童医院收治的行支气管镜气道异物取出术的患儿291例,对患儿临床资料进行回顾性分析,将术中及术后24 h内未发生呼吸系统严重并发症的患儿作为无并发症组,将术中及术后24 h内发生呼吸系统严重并发症的患儿作为并发症组。对比两组一般资料、手术时间、异物存留时间、异物位置、异物类型等资料,再对单因素分析中差异有统计学意义的因素进行logistic回归分析,确定患儿发生围术期呼吸系统严重并发症的危险因素。计量资料采用独立样本t检验,计数资料采用χ²检验。结果　291例患儿共37例发生并发症,发生率为12.71%（37/291）。并发症组男19例、女18例,年龄（3.12±0.51）岁;无并发症组男163例、女91例,年龄（3.19±0.59）岁。并发症组患儿手术时间、异物存留时间、术前呼吸道感染及麻醉效果不佳比例分别为（20.12±4.05）min、（7.09±0.48）d、51.35%（19/37）、70.27%（26/37）,均高于无并发症组［（12.18±1.11）min、（3.61±0.55）d、12.99%（33/254）、7.48%（19/254）］,差异均有统计学意义（均P<0.05）。多因素logistic回归分析发现手术时间、异物存留时间、术前呼吸道感染、麻醉效果不佳是患儿围术期呼吸系统严重并发症发生的危险因素（均P<0.05）。结论　支气管镜气道异物取出术患儿围术期呼吸系统严重并发症的危险因素主要为手术时间、异物存留时间、术前呼吸道感染、麻醉效果不佳,临床应警惕并及时采取预防措施。     

纤维支气管镜下支气管异物取出术的临床应用

目的探讨支气管异物的临床特征并总结诊疗经验,综合评价纤维支气管镜在诊治支气管异物中的价值。方法回顾性分析经纤维支气管镜诊治的支气管异物28例。结果支气管异物右侧多见,且大部分为非金属异物,纤维支气管镜钳取支气管异物成功率达96％,术后咳嗽及胸痛缓解。结论无明确异物吸人史或异物吸入史不详者易误诊,应详细询问病史并重视胸部X线检查结果。纤维支气管镜是目前诊治支气管异物的最有效手段。     

角膜深层异物取出术的探讨

目的:探讨角膜深层异物的取出方法。方法:角膜深层异物有外露或伴刺入前房不易滑动者,用剔除法取出异物。异物在角膜基质深层无外露或伴刺入前房,不易滑入前房者,可用角膜切开法取异物。异物无外露,刺入前房且易于滑动者,须经前房内取出。结果:本组37例角膜深层异物中,用剔除法取出30例;用角膜切开法取出4例;前房内取出法3例。所有异物均顺利取出。仅有4例异物取出后角膜异物贯通伤口处有明显混浊、浸润,经抗感染后消退。留有角膜云翳,影响视力。结论:对于角膜深层异物要视异物刺入的深度、位置、性质及估计其取出的难易程度,采用剔除法、角膜切开法和经前房内取出法取出异物。只要方法得当,则可以减少对眼内组织损伤而安全取出异物。     

小儿气管异物取出术并发症的防治

气管异物是耳鼻喉科常见的急症之一，异物吸入后常有不同程度的呼吸困难，若异物完全阻塞呼吸道可致突然死亡，因此，均需急诊异物取出，否则后果极为严重。我院１９８６年８月～１９９６年８月，共行小儿气管异物取出术１６４例，发生意外和并发症５３例，占３２３％，...