论文部分内容阅读
目的探讨两种不同麻醉通气方式在小儿气管异物取出术中的应用效果。方法选取梧州市红十字会医院2010年1月—2015年1月行气管异物取出术患儿40例。随机将患儿分为A组与B组,各20例。A组予以氯胺酮+丙泊酚麻醉自主呼吸通气,B组予以氯胺酮+丙泊酚+顺式阿曲库铵麻醉控制呼吸通气。比较两组患儿麻醉前后心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2)水平、手术时间、麻醉恢复时间及呛咳、屏气或喉痉挛、缺氧(SpO_2<90%)2 min等不良反应发生率。结果麻醉前两组患儿HR、MAP及SpO_2水平比较,差异无统计学意义(P>0.05);麻醉后B组HR、MAP水平低于A组,SpO_2水平高于A组(P<0.05);麻醉后两组患儿HR水平低于麻醉前,A组麻醉后MAP水平高于麻醉前,SpO_2水平低于麻醉前(P<0.05)。B组手术时间、麻醉恢复时间短于A组(P<0.05);B组呛咳、屏气或喉痉挛、缺氧2 min发生率低于A组(P<0.05)。结论氯胺酮+丙泊酚+顺式阿曲库铵控制呼吸在小儿气管异物取出术中的应用效果明显,可有效稳定血流动力学,缩短手术时间及麻醉恢复时间,且不良反应少。
Objective To explore the effect of two different anesthesia ventilation methods in the removal of pediatric tracheal foreign bodies. Methods Forty children with tracheal foreign body removal were selected from Wuzhou Red Cross Hospital from January 2010 to January 2015. The children were randomly divided into A group and B group, 20 cases each. Group A received ketamine + propofol anesthesia for spontaneous breathing ventilation, and group B received ketamine + propofol + cisatracurium for anesthesia to control respiratory ventilation. The heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), operation time, anesthesia recovery time and choking, breath holding or laryngospasm, hypoxia (SpO_2 <90% ) 2 min and other adverse reactions. Results There was no significant difference in HR, MAP and SpO_2 levels between the two groups before anesthesia (P> 0.05). HR and MAP levels in group B were lower than those in group A after anesthesia, and SpO_2 levels were higher than those in group A (P <0.05) The levels of MAP in the two groups were lower than those before anesthesia. The levels of MAP in group A were higher than those before anesthesia, and the levels of SpO_2 were lower than those before anesthesia (P <0.05). In group B, the recovery time of anesthesia was shorter than that of group A (P <0.05). In group B, the incidence of choking, breath holding or laryngospasm and hypoxia 2 min was lower than that of group A (P <0.05). Conclusions Ketamine + propofol + cisatracurium is effective in controlling the respiration of pediatric tracheal foreign body removal, which can effectively stabilize the hemodynamics, shorten the operation time and recovery time of anesthesia with less adverse reactions.