异丙酚静脉复合麻醉在小儿支气管镜检查术中的应用

目的　探讨异丙酚静脉复合麻醉在儿童支气管镜检查术中的应用。方法　在以异丙酚为主的静脉复合麻醉下对 5 6例患儿进行了 62例次支气管镜检查 ,其中硬质支气管镜检查5 0例次 ,纤维支气管镜检查 1 2例次 ;6例同时行局部冲洗或肺泡灌洗。结果　 62例次支气管镜检查过程中 ,1例并发双侧气胸及纵隔气肿 ;1例出现喉痉挛 ;1例因缺氧发作终止操作。全部患儿无呼吸抑制、低血压、心律失常、出血及死亡。术前怀疑异物吸入 44例中 ,经硬质支气管镜检查 ,发现异物 32例 ,分泌物阻塞 (痰栓 ) 1 0例 ,肉芽肿 2例。反复或持续肺炎 1 1例经纤维支气管镜检查及局部冲洗或肺泡灌洗检查 ,7例治愈 ,2例好转 ;1例确诊为特发性肺含铁血黄素沉着症 ,1例右上肺实变仍诊断不明。 1例不明原因咯血 ,经检查发现右主支气管黏膜 3处糜烂。结论　异丙酚静脉复合麻醉安全、副作用少 ,是儿童支气管镜检查的一种理想的麻醉方式。

Application of propofol to the bronchoscopy in children

Objective To evaluate the efficiency of intravenous anesthesia with propofol in bronchoscopy in children.Methods Intravenous anesthesia with propofol was used in 62 bronchoscopy procedures in 56 children,50 of 62 procedures performed by rigid bronchoscopy,12 of 62 procedures performed by flexible fiberoptic bronchoscopy,6 patients received bronchoalveolar lavage.Results During the 62 procedures,1 had pneumothorax,1 had laryngospasm,and one hypoxemic spells.No patients had breath inhibition,hypertension,bleeding and death.Among 44 patients suspected foreign body aspiration,32 had foreign body,10 had secretion obstruction and 2 had granuloma.Among 11 patients with recurrent or persistent pneumonia,9 had improved or cured,1 was diagnosed as pulmonary hemosiderosis,1 was not diagnosed.1 patient with hemoptysis was found the lesions in trachea.Conclusion Intravenous anesthesia with propofol is safe in the children undergoing bronchoscopy.