七氟醚在小儿支气管异物术中的应用

目的观察七氟醚在小儿支气管异物术中的麻醉效果。方法 50例支气管异物患儿随机分为观察组和对照组各25例。观察组采取七氟醚吸入麻醉;对照组采用静脉注射芬太尼复合丙泊酚麻醉。观察诱导期患儿表现,记录患儿睫毛反射消失时间、苏醒时间,监测并记录诱导前、置入支气管镜后5min的心率、SPO2和呼吸频率。结果观察组躯体运动、屏气呛咳、喉痉挛、分泌物增多发生率均低于对照组,差异有统计学意义(P<0.05)。观察组睫毛反射消失时间、苏醒时间短于对照组,差异均有统计学意义(P<0.05)。置管5min时观察组心率、呼吸频率均高于诱导前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论七氟醚在小儿支气管异物术中的应用效果显著。     

七氟醚在小儿气管异物取出术中的应用

目的观察七氟醚吸入麻醉在小儿气管异物取出术中的麻醉效果     

七氟醚联合异丙酚在小儿气管异物取出术中的应用

目的观察七氟醚联合异丙酚静吸复合全麻下行小儿气管异物取出术的麻醉效果。方法46例拟施气管异物取出术的患儿随机分为2组:七氟醚组(S组),羟丁酸钠组(R组)。观察支气管镜置镜条件满意度;记录麻醉至手术开始时间、手术时间及麻醉苏醒时间;观察各项生命指标的变化及并发症的情况。结果两组都能够达到良好的置入喉镜满意度;七氟醚组苏醒时间短且苏醒效果佳,与羟丁酸钠组比较,差异有统计学意义(P<0.05);两组均无明显的并发症发生。结论在急诊小儿气管异物取出术中应用七氟醚及异丙酚麻醉,可以达到良好的麻醉效果,是一种安全有效的麻醉方法。     

七氟醚复合丙泊酚麻醉在小儿气管异物取出术中的应用

对在小儿气管异物取出术中使用七氟醚复合丙泊酚麻醉的诱导维持及苏醒特点进行探讨,报告如下:     

七氟醚吸入全麻在小儿气管异物取出术中的临床应用

目的:观察小儿气管异物取出术中吸入七氟醚的效果.方法:40例ASA Ⅰ～Ⅱ级1～2岁患儿均行七氟醚吸人全麻.监测氧饱和度(SpO2)、心率(HR)、呼吸频率(RR),观察患儿吸入七氟醚后的镇静、肌松程度和麻醉诱导、维持期、苏醒期的精神反应情况.结果:七氟醚吸入全麻在小儿气管异物取出术中,对氧饱和度基本无明显影响,诱导及术中心率稍快,镇静、肌松程度良好,诱导期患儿较平静,术中血流动力学较平稳,术后苏醒快、质量较高.结论:七氟醚吸入全麻药,可产生良好的镇静、肌松作用,喉痉挛、呼吸抑制等并发症发生率低,可减少麻醉诱导、维持期、苏醒期的精神反应,适用于小儿气管异物取出术,效果满意,安全可靠.     

七氟醚在小儿气管异物取出术麻醉中的临床研究

目的分析并评价七氟醚在小儿气管异物取出术中的麻醉效果。方法对我院自2008年1月至2010年12月期间收治的36例ASAⅠ～Ⅱ级气管吸入异物患儿实施气管异物取出术,术前采用七氟醚吸入进行全麻。结果本组全部36例患儿呼吸道异物均被成功取出。患儿在诱导期的意识消失速度较快,仅1例患儿出现哭闹现象,并有少量的呼吸道分泌物;患儿从吸入七氟醚直到入睡平均用时(1.17±0.37)min;术中HR与RR略有增加,SpO2与PETCO2未见显著变化,肌松程度及镇静效果理想,插入支气管镜过程顺利,全部36例患儿均一次性完成手术,用时5～15min,术后患儿停药直到苏醒平均用时(3.50±0.61)min。结论七氟醚在小儿气管异物取出术中作为吸入全麻药,具有理想的镇静及肌松效果,麻醉效果安全可靠,可作为小儿气管异物取出术麻醉的首选方法。     

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。     

七氟醚吸入麻醉在食道异物取出术中的应用

目的观察七氟醚全凭吸入麻醉下行食道异物取出术的麻醉效果。方法采用七氟醚全凭吸入麻醉应用于35例食道异物患者行食道异物取出术,同时观察并记录麻醉诱导、维持过程中生命体征及术后并发症情况。结果 35例食道异物患者均顺利完成手术,术者及患者均对麻醉效果满意。结论七氟醚全凭吸入麻醉应用于食道异物取出术安全、迅捷、高效,患者舒适度高,并发症少见,值得推广应用。     

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.     

个体化护理在小儿支气管异物摘取术中的应用

目的 探讨个体化护理在小儿支气管异物摘取术护理中的应用效果.方法 将行支气管异物摘取术患儿116例随机分成观察组和对照组,各58例.观察组根据不同个体采用个体化护理,对照组采用常规护理.护理后比较2组1次性异物取出成功率及并发症情况.结果 观察组1次性异物取出成功率为96.6%高于对照组的81.0%,差异有统计学意义(P＜0.05).观察组并发症总发生率为3.4%低于对照组的20.7%,差异有统计学意义(P＜0.05).结论 个体化护理能提高支气管异物摘取术患儿的护理质量.     

个体化护理在小儿支气管异物摘取术中的应用

目的探讨个体化护理在小儿支气管异物摘取术护理中的应用效果。方法将行支气管异物摘取术患儿116例随机分成观察组和对照组,各58例。观察组根据不同个体采用个体化护理,对照组采用常规护理。护理后比较2组1次性异物取出成功率及并发症情况。结果观察组1次性异物取出成功率为96.6%高于对照组的81.0%,差异有统计学意义（P〈0.05）。观察组并发症总发生率为3.4%低于对照组的20.7%,差异有统计学意义（P〈0.05）。结论个体化护理能提高支气管异物摘取术患儿的护理质量。     

Spontaneous expectoration of bronchial foreign body: a case report

A nine-year-old girl with mental retardation accidentally swallowed an axle of a toy car and was urgently hospitalized with the diagnosis of left bronchial foreign body. While various monitors were installed and removal of the foreign body by a ventilating rigid bronchoscope was in preparation, the patient suddenly coughed and vomited, with the foreign body found in the vomit. When examining infant cases of air way foreign body, attention tends to be focused on the diagnosis and treatment. However, patients are at risk of aggravating difficulty in breathing or suffocation as long as foreign bodies are present in the air way. It is important to monitor carefully for changes in the breathing and to prepare for unexpected events.     

小儿气管支气管异物76例临床分析

目的 探讨小儿支气管异物的临床特点、诊断及治疗.方法 回顾性分析我院2010年3月至2011年5月收治的76例小儿气管、支气管异物患者的临床资料.结果 本组76例小儿气管、支气管异物患者,术前咳出2例,全麻或表麻下顺利取出异物73例,术后并发心衰1例.结论 小儿气管、支气管异物快速准确的诊断、治疗以及并发症预防是挽救患儿生命的关键.     

小儿支气管异物取出手术麻醉方式的选择

目的:探讨小儿支气管异物取出手术安全可靠的麻醉方式.方法:回顾性分析481例小儿支气管异物患儿分别使用全身麻醉和咽部黏膜表面麻醉进行异物取出术的治疗效果.结果:全身麻醉下行支气管异物取出术296例中1次成功取出异物295例,失败率为0.34%;1%丁卡因咽部黏膜表面麻醉下行支气管异物取出术185例中1次成功取出异物175例,失败率为5.40%,2次成功取出异物8例,术后并发喉头水肿10例,其中使用全身麻醉2例,1%丁卡因咽部黏膜表面麻醉8例;术后并发喉痉挛12例,其中使用全身麻醉1例;行气管切开4例,窒息死亡2例,死亡率为0.42%,皆为使用1%丁卡因咽部黏膜表面麻醉者.结论:全身麻醉下行支气管异物取出术1次成功与失败率明显低于黏膜表面麻醉下行支气管异物取出术,术后并发症少,值得临床推广应用.     

瑞芬太尼复合利多卡因在小儿气管异物取出术中的应用

目的观察瑞芬太尼复合利多卡因在小儿气管异物取出术中的应用效果。方法气管异物患儿40例,随机分为R组和F组,每组20例。均入室后吸入七氟醚,入睡后行静脉穿刺,静脉穿刺后停止吸入七氟醚。之后R组静脉注射1%利多卡因3mg.kg-1,静脉泵注异丙酚50～150μg.kg-1.min-1、瑞芬太尼0.1～0.5μg.kg-1.min-1和静脉注射维库溴铵0.05 mg.kg-1维持麻醉(R组,n=20);F组静脉穿刺后不注射利多卡因,而是静脉泵注异丙酚50～150μg.kg-1.min-1、静脉注射芬太尼2μg.kg-1和静脉注射维库溴铵0.05 mg.kg-1维持麻醉(F组,n=20)。术中经硬质支气管镜侧孔行高频通气。记录各时点血流动力学变化,对比两组患儿术中体动、屏气呛咳、低氧饱和度(SpO2降至90%以下)、硬质气管镜退镜次数以及术后呛咳、躁动发生率,并比较手术时间和苏醒时间。结果两组术中患儿术中体动、低氧饱和度、支气管镜退镜次数、手术时间和术后躁动无统计学差别,R组术中、术后呛咳发生率少、苏醒更加迅速、术中血流动力学更稳定。结论瑞芬太尼复合利多卡因在小儿气管异物取出术中的应用,术中术后并发症少,苏醒迅速且苏醒质量高。     

急诊胃镜检查在小儿误吞异物中的应用

目的分析急诊胃镜检查在小儿误吞异物中的应用效果。方法选取2008年2月至2013年2月接收的误吞异物小儿患者50例,均采用急诊胃镜检查并取出异物,对异物的取出时间、异物取出至出院时间,以及一次性异物成功取出率和并发症发生率分布进行统计。结果异物的平均取出时间为（12.4±4.6）min,异物取出后至出院时间平均为（26.5±7.2）h;一次性成功取出异物率为100.0%;并发症发生率2.0%;异物取出临床效果整体比较理想。结论急诊胃镜在小儿误吞异物中整体应用效果显著,一次性成功取出率高,且安全性高,值得临床推广。