关于全麻术中保留自主呼吸的小儿喉罩麻醉效果分析

目的：探讨小儿喉罩麻醉保留自主呼吸在全麻术中的应用效果。方法选取2011年1月—2013年1月期间该院接收的68例择期行全麻手术治疗的患儿作为研究对象,所有患儿术中均保留自主呼吸。对患儿诱导前及置喉罩后不同时间点血氧饱和度（SpO2)、血流动力学、呼末二氧化碳(PETCO2)变化情况进行观察分析。结果该组患儿置入喉罩后不同时间点血压、心率等较诱导前均有所改变（P<0.05）,患儿血氧饱和度较诱导明显升高（P<0.05）;术中患儿PETCO2无明显变化,均保持在正常范围内。结论将小儿喉罩麻醉保留自主呼吸应用于全麻手术中可取得较好的效果,且具有术中血流动力学稳定、无缺氧及二氧化碳蓄积现象发生等优点,具有较高的应用价值,可在临床上推广应用。     

小儿阑尾切除术1472例分析

目的 分析l472例小儿阑尾切除术的疗效，探讨小儿阑尾炎的诊治方法。方法 我院1982.8—2002．12行小儿阑尾切除术l472例。其中男l163例，女309例，男：女=3．76：l；平均年龄5．7岁(8天至14岁)，6～14岁973例(66．10％)。急诊手术1164例(79。08％)，择期手术308例(20．92％)，脓肿引流4例(0．27％)，阑尾切除1468例(99．73％)，其中296例(20．1l％)是在先天性巨结肠根治术或Meckel憩室切除术等手术中一并行阑尾切除的。结果 急性阑尾炎阑尾切除术后伤口感染83例(7．4％)，粘连性肠梗阻1l例(0．75％)，阑尾残端瘘3例(0．20％)，腹内脓肿3例(0.20％)，死亡l例(0.07％)。结论 小儿急性阑尾炎误诊率及手术前后并发症率高，小儿阑尾炎应早期诊断及尽早手术治疗。     

Pediatric choking

Choking episodes and foreign body aspiration can be life threatening or result in significant morbidity. Choking continues to be a direct cause of death among children, most commonly occurring between the ages of one and four years. Various strategies have been used to decrease choking risks and prevent adverse outcomes. These have included alterations in product design and public education campaigns. Although education has been partially successful, primary care physicians can play a critical role in increasing education efforts during each well child office visit through anticipatory guidance of choking risks. Management of a choking child often involves collaborative efforts from the primary care physician, emergency room physician, otolaryngologist, pulmonologist, and radiologist. The purpose of this brief review is to provide an overview of the epidemiology and pathophysiology of choking and foreign body aspiration in children and to highlight important aspects of prevention and patient education.