婴儿气管内异物取出术麻醉中的呼吸管理

目的：探讨采用Rees呼吸回路对婴儿气管异物取出术麻醉进行呼吸管理，以提高麻醉的安全性。方法：40例婴儿按给氧方式随机分为A组（20例）和B组（20例），两组麻醉用药相同，A组置镜后通过气管镜侧壁孔给氧3-5ml／min，B组通过气管镜侧壁孔连接Rees呼吸回路．当呼吸慢或SpO2下降时行辅助呼吸。记录术前（T1）、诱导后（T1）、置入气管镜后2分钟（T3）、退出气管镜时（T4）、手术结束后5分钟（B）时的SBP、DBP、SpO2、PR、HR。结果：B组婴儿T3、T4时间点SpO2明显高于A组（P〈0．05），其余指标两组差异无显著性。结论：采用Rees呼吸回路对婴儿气管异物取出术麻醉进行呼吸管理可根据需要对患儿进行辅助或控制呼吸，取得了呼吸的控制权．保证了良好的通气和氧供．较大地提高了麻醉的安全性。

Respiration management in anesthesia of taking out the intratracheal foreign body in infants

Objective:To adopte the respiratory circuit system of Rees for the respiration management,so as to improve the safety of anesthesia in taking out the intratracheal foreign body in infants.Methods:Forty infants were randomly divided into group A(n=20) and group B(n=20) according to their oxygen-supply method.They were given the same medicine in anesthesia,group A was supplied oxygen 3~5 ml/min through the side wall bore of tracheoscope after placing the scope,while group B was jointed with the respiratory circuit system of Rees through the side wall bore of tracheoscope.It was time to perform the assistance ventilation when the breath became slow or the SpO2 descended.SBP,DBP,SpO2,PR and HR were recorded before the operation(T1) and after induction of anesthesia(T2) and 2 minutes after placing tracheoscope(T3) and in the case of taking out the tracheoscope(T4) and 5 minutes after the operation(T5) respectively.Results:The SpO2 of the group B was significantly higher than that of the group A in T3 and T4(P<0.05),no significant difference was found in the rest indices between two groups.Conclusion:Adopting the respiratory circuit system of Rees to management respiration in anesthesia taking out the intratracheal foreign body may assist or control respiration according to demand at any time.It may obtain the respiratory control power,guarantee the good ventilation and oxygen supply and improve the safety of anesthesia considerably.