单纯丙泊酚-司可林复合全麻用于小儿气管异物取出术中的临床观察.docVIP

单纯丙泊酚-司可林复合全麻用于小儿气管异物取出术中的临床观察 【摘要】 目的 观察单纯丙泊酚-司可林复合全麻用于小儿气管异物取出术的麻醉效果。方法 60例患儿随机分为两组，丙泊酚-司可林麻醉组（S组，n=30），传统的麻醉方法组即r-OH复合氯胺酮麻醉组（K组，n=30），术中持续监测SpO2、HR、NIBP及ECG，并观察术中呛咳、喉痉挛、手术时间、苏醒时间和术后舌后坠发生率。结果 S组中SpO2变化不大，而K组SpO2术中波动较大（P＜0.05），两组术中NIBP、HR及ECG均变化不大（P＞0.05），S组手术时间、苏醒时间明显较K组缩短（P＜0.05），术中呛咳、喉痉挛及术后舌坠发生率S组明显低于K组（P＜0.01）。结论 单纯丙泊酚-司可林复合麻醉用于小儿气管异物取出术是一种简单、安全、有效、实用的麻醉方法。 【关键词】 丙泊酚；小儿；全麻；气管异物 【Abstract】 Objective To observe the anaesthesia effect of the abnormal-objects extraction in trachea of children by pure propofol-scoline combined with anaesthesia method.Methods 60 ill kids were divided into two groups at random, namely the propofol-scoline group （Group S, n=30） and the traditional anaesthesia method group （Group K, n=30）. During the operation, SpO2, HR, NIBP and ECG were inspected continuously, moreover, choke, cough, throat hyperkinesia, time for operation, waking-up time and tongue fall back occurrence frequency were also under the inspection.Results SpO2 in Group S owned little variation, while SpO2 in Group K fluctuated a lot （P＜0.05）. NIBP, HR and ECG in both two groups had little variation. Time for operation and waking was shortened obviously as compared Group S with Group K （P＜0.05）. The frequency of choke and cough during the operation and tongue fall back occurrence was more minimum as compared Group S with Group K （P＜0.01）. Conclusion The pure propofol-scoline combined with anaesthesia method is a simple, safe, effective and practical method in trachea abnormal-objects extraction operation of children. 【Key words】 Propofol;kid;general anaesthesia;abnormal-objects in trachea 气管异物患儿病情危急，常伴有不同程度的呼吸困难及低氧，加之小儿的呼吸循环功能较差，对低氧的耐受力差，因此全麻方式的选择至关重要。传统的r-OH复合氯胺酮麻醉方法因用药量大，麻醉深浅不易控制，麻醉作用时间长，而且术中患儿常出现挣扎、呛咳而影响手术操作，常因屏气而SpO2迅速下降而需反复退镜面罩加压给氧至SpO2正常后再置镜，因此增加了手术时间及反复置镜对咽喉、气管的损伤，本文比较了丙泊酚-司可林复合全麻和r-OH复合氯胺酮全麻在小儿气管异物取出术中的应用，探讨其麻醉效果及安全性、可控性、实用性报告如下。 　　 1 资料与方法 1．1 一般资料 60例气管异物患儿年龄6个月～5岁。采用随机数字表法随机分为丙泊酚-司可林麻醉组（S组，n=30）和r-OH复合氯胺酮麻醉组（K组，n=30），异物种类：花生米27例，瓜子14例，笔帽10例，其他9例。 1．