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目的探讨自制三通喉罩通气在纤维支气管镜小儿气管、支气管异物取出术中的应用。方法实施气管、支气管异物取出术的小儿患者15例,麻醉风险评估(ASA)Ⅰ～Ⅱ级,年龄2.5～11岁。在快速诱导麻醉下插入自制三通喉罩。三通喉罩一端口连接麻醉机进行机械控制通气,从另一带有密封胶帽端口置入支气管镜,经声门进入气管、支气管,实施异物取出术。术中监测收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏氧饱和度(SpO2)、潮气量(VT)、气道峰压(Ppeak)及呼气末二氧化碳分压(PETCO2)。记录麻醉、手术效果和过程。结果15例手术均顺利完成,SpO2在麻醉诱导开始后有明显改善;手术时间8～36min,平均16min;麻醉时间39～60min,平均45min。术后恢复良好,无明显并发症。结论自制三通喉罩用于小儿气管异物取出术安全、可靠,效果满意。
Objective To investigate the application of self-made three-way laryngeal mask ventilation in the removal of pediatric tracheal and bronchial foreign bodies in patients with bronchofibroscopy. Methods Fifteen pediatric patients with tracheal or bronchial foreign body removal were enrolled in this study. Anesthesia Risk Assessment (ASA) Ⅰ ~ Ⅱ grade, age ranged from 2.5 to 11 years old. Insert a self-made three-way laryngeal mask under rapid induction of anesthesia. A three-way laryngeal mask connected to a mechanical anesthesia machine for ventilation, from the other with a sealant cap port into the bronchoscope, the glottis into the trachea, bronchus, the implementation of foreign body removal. Intraoperative SBP, DBP, SpO2, VT, Ppeak and PETCO2 were monitored intraoperatively, ). Record anesthesia, surgical effects and procedures. Results All the 15 cases were successfully completed. SpO2 was significantly improved after induction of anesthesia. The operative time ranged from 8 to 36 minutes with an average of 16 minutes. The anesthesia time ranged from 39 to 60 minutes with an average of 45 minutes. Postoperative recovery was good, no significant complications. Conclusion Self-made three-way laryngeal mask for pediatric tracheal foreign body removal is safe, reliable and satisfactory results.