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我院自1996年10月～1997年9月观察了39例先天性心脏病患儿心脏直视手术时气管导管气囊内压力(ICP)的变化,并对气管插管后并发症进行了随访。资料与方法本组男21例,女18例,年龄6.6±3.75岁,体重20.32±8.26kg。其中室间隔缺损、房间隔缺损28例,法鲁氏四联症、五联症9例,肺动脉瓣狭窄2例,均在体外循环下行心脏直视手术。以氯胺酮、芬太尼和潘库溴铵静脉诱导气管插管,用低压气囊导管(Sheridan,美国),导管号码ID:5.03±0.66mm。插管后接麻醉机,吸100%氧和2%～3%安氟醚,静脉复合芬太尼30～40μg/kg和潘库溴铵0.1mg/kg维持麻醉。经三通向套囊内注气,接压力传感器测压,调节ICP至3kPa,为基础值(T0)。全程手法控制呼吸,用COL-IN-508监护仪(日本)监测心电、血压、ICP、肛温、鼻温和呼气末二氧化碳浓度,脉搏氧和CVP。记录以下各点ICP:手术开始(T1)、劈开胸骨(T2)、体外循环开始
In our hospital from October 1996 to September 1997 observed 39 cases of congenital heart disease in children with open heart surgery tracheal tube balloon pressure (ICP) changes, and tracheal intubation complications were followed up. Materials and Methods The group of 21 males and 18 females, aged 6.6 ± 3.75 years old, weighing 20.32 ± 8.26kg. Ventricular septal defect, atrial septal defect in 28 cases, tetralogy of Fallot, five cases of 9 cases, pulmonary stenosis in 2 cases, undergoing cardiopulmonary bypass cardiopulmonary bypass surgery. Tracheal intubation was induced intravenously with ketamine, fentanyl, and pancuronium using a low pressure balloon catheter (Sheridan, U.S.A.) catheter ID: 5.03 ± 0.66 mm. After intubation anesthesia machine, inhaled 100% oxygen and 2% to 3% enflurane, intravenous fentanyl 30 ~ 40μg / kg and pancuronium 0.1mg / kg to maintain anesthesia. The three-way gas into the cuff, then pressure sensor pressure measurement, adjust ICP to 3kPa, based on the value (T0). The whole procedure was to control the respiration. The ECG, blood pressure, ICP, rectal temperature, nasal temperature and end expiratory carbon dioxide concentration, pulse oxygen and CVP were monitored using a COL-IN-508 monitor (Japan). Record the following points ICP: Start of surgery (T1), split sternum (T2), cardiopulmonary bypass