摘要
目的评估硬支气管镜置入评分下，喉罩联合T型密封接头静脉全麻在小儿纤维支气管镜（纤支镜）检查中的效果及安全性。方法选择2012年6～12月，年龄1～2岁，拟行纤支镜检查的40例患儿，随机均分为喉罩全麻组（L组）和静脉全麻组（C组）。L组患儿通过硬支气管镜置人评分后，喉罩联合T型密封接头管理通气，保留自主呼吸。C组患儿在常规静脉全麻下行纤支镜检查，保留患儿自主呼吸，经面罩辅助通气。观察两组患儿纤支镜检查前（T1）、纤支镜检查开始后5min（T2）、10min（T3）和15min（TI）血流动力学的变化；记录检查中呛咳、呼吸抑制、体动和低氧血症等不良反应的发生情况。结果，T2～T4时C组患儿HR明显快于，MAP明显高于，Sp02明显低于L组和T，时（P〈0．05），不同时点L组HR、MAP及SpQ差异无统计学意义。C组患儿检查中呛咳、呼吸抑制、体动和低氧血症等不良反应发生率明显高于L组（P〈0．05）。结论硬支气管镜置入评分下，喉罩联合T型密封接头全麻保留自主呼吸管理用于小儿纤支镜检查安全、有效，不良反应少，有很好的临床应用价值。
Objective To evaluate the clinical effects and safety of general anesthesia with laryngeal mask airway in fiberoptic bronchoscopy in children with ratings placed under rigid bronchoscope. Methods Forty children,aged 1-2 years,were randomly divided into two groups（n=20 in each） . the patients with ratings placed under rigid bronchoscope in group L used laryngeal mask airway combined with T-seal adapter and maintained spontaneous breathing during fiberoptie bronchoscopy, and the patients in group C received total intravenous anesthesia, who also maintained spontaneous respiration and might receive assisted ventilation via {ace mask if necessary. Fiberoptic bronchoscopy in group C was carried out after surface anesthesia. The heart rate（HR）,mean arterial pressure（MAP） and pulse oxygen saturation（SpO2 ）were recorded at the time before（T1 ）, 5 min（T2 ）, 10 min（T3）and 15 rain（T4 ）after start of fiberoptic bronchoscopy. Adverse effects such as irritating cough, breathlessness, limb movements and hypoxemia were recorded. Results The HR and MAP were significantly higher and the SpO2 was significantly lower in group C at T2-T4 compared to those at T1 in the same group and those in group L at the same time point （P〈 0.05）. There were significantly less irritating cough, breathlessness, body movements or hypoxemia in group L（P〈 0.05）. Conclusion Maintaining spontaneous ventilation with laryngeal mask airway and T-seal adapter with ratings placed under rigid bronchoscope is a safe and effective alternative to painless fiberoptic bronchoscopy in children.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第11期1076-1078,共3页
Journal of Clinical Anesthesiology
关键词
喉罩
纤维支气管镜检查
小儿
自主呼吸
Laryngeal mask airway
Fiberoptic bronchoscopy
Children
Spontaneous respiration
