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目的探讨喉罩全麻下控制呼吸与自主呼吸在患儿纤维支气管镜(纤支镜)手术中的应用效果的对比。方法选取2013年3月至2014年3月住院行纤支镜手术的66例患儿为研究对象,按就诊顺序号将上述患者分为对照组(自主呼吸组)和观察组(控制呼吸组),每组均为33例。对两组患儿不同时点的生命体征(T0~T4)及血气分析指标(T1~T4)和围术期不良反应进行比较。结果组间比较,患儿的手术时间、手术中断次数和瑞芬太尼使用量等差异均有统计学意义(P均<0.05);T2与T3时MAP、HR、SpO2、PETCO2及VT等指标比较有明显差异(P均<0.05),pH、PaCO2、PaO2、BE和SaO2等指标比较也有明显差异(P均<0.05)。对照组呛咳、憋气、肢体运动等不良反应发生率均高于观察组(P均<0.05),喉痉挛、躁动和恶心呕吐等不良反应发生率组间比较差异无统计学意义(P均>0.05)。结论患儿纤支镜手术中于喉罩全麻下控制呼吸更为安全有效,还可降低不良反应的发生率。
Objective To compare the effects of controlled respiration and spontaneous breathing under general anesthesia in children under general anesthesia with bronchofibroscopy. Methods Sixty-six children undergoing fiberoptic bronchoscopy from March 2013 to March 2014 were selected as study subjects. The patients were divided into control group (spontaneous breathing group) and observation group (control breathing group) , Each group was 33 cases. The vital signs (T0 ~ T4), blood gas analysis indexes (T1 ~ T4) and perioperative adverse reactions were compared between the two groups at different time points. Results There were significant differences in the operation time, the number of surgical interruptions and the remifentanil usage between the two groups (all P <0.05). The indexes of MAP, HR, SpO2, PETCO2 and VT at T2 and T3 (P <0.05). The indexes of pH, PaCO2, PaO2, BE and SaO2 were also significantly different (all P <0.05). The incidence of adverse reactions in the control group such as cough, suffocation and limb movement were significantly higher than those in the observation group (P <0.05). There was no significant difference in adverse reactions such as laryngospasm, agitation and nausea and vomiting between the two groups (P> 0.05). Conclusion In children with bronchofibroscopy surgery, laryngeal mask anesthesia to control breathing more safe and effective, but also reduce the incidence of adverse reactions.