纤维支气管镜引导下气管插管在小儿鼾症麻醉中的应用

发布时间：2018-03-13 03:37

本文选题：纤维支气管镜　切入点：气管插管　出处：《中国微创外科杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨纤维支气管镜(纤支镜)引导下气管插管在小儿鼾症手术麻醉中的应用价值。方法选取2015年8月~2016年6月小儿鼾症手术50例,将其分为纤支镜组和喉镜组,各25例。观察2组于纤支镜或常规金属光纤麻醉喉镜下气管插管一次插管成功的例数、插管所用时间、手术过程中气管导管脱出例数以及不良反应发生率。结果纤支镜组全部气管导管一次插管成功,插管所用时间(20.1±4.3)s,位置正确,麻醉全程无需调整。喉镜组3例由于扁桃体太大无法暴露咽腔插管2次成功,3例在调整体位时气管导管脱出,一次插管成功率76%(19/25),插管所用时间(50.7±6.9)s。纤支镜组一次插管成功率、插管所用时间明显优于喉镜组(Fisher检验,P=0.022;t=-18.725,P=0.000)。纤支镜组无一例咽部出血、牙齿松动或脱落以及喉痉挛等不良反应,喉镜组3例插管后咽部出血,3例牙齿有不同程度松动和脱落,1例2次插管者喉痉挛,不良反应发生率2组差异无显著性(P0.05)。结论小儿鼾症手术麻醉中应用纤支镜引导下气管插管不良反应少,安全性高。
[Abstract]:Objective to evaluate the value of fiberoptic bronchoscopy (fiberbronchoscope) guided tracheal intubation in the anesthesia of pediatric snoring. Methods 50 cases of pediatric snoring from August 2015 to June 2016 were divided into fiberoptic bronchoscope group and laryngoscope group. 25 cases in each group were treated with fiberoptic bronchoscope or conventional metal fiber optic anaesthesia laryngoscope, the number of successful intubation cases and the time of intubation were observed. Results all tracheal ducts in fiberoptic bronchoscopy group were successfully intubated at one time, the time of intubation was 20.1 卤4.3 s, and the position was correct. In laryngoscope group, 3 cases were successfully intubated in pharynx cavity because their tonsils were too large to be exposed twice, and 3 cases had extubation of trachea catheter when adjusting body position, the success rate of intubation was 76 / 25, the time of intubation was 50.7 卤6.9 / s. The successful rate of intubation was 50.7 卤6.9 / s in fiberoptic bronchoscope group. The intubation time was better than that in laryngoscope group by Fisher's test. There were no adverse reactions such as pharyngeal hemorrhage, tooth loosening or falling off, laryngeal spasm and so on in the fiberoptic bronchoscopy group. Laryngoscope group (3 cases) with pharyngeal hemorrhage after intubation, 3 cases with loosening of teeth and 1 case with second intubation of laryngospasm. There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion the tracheal intubation under the guidance of fiberoptic bronchoscope in children snoring surgery anesthesia has less adverse reactions and higher safety.
【作者单位】：徐州医科大学附属宿迁医院南京鼓楼医院集团宿迁市人民医院耳鼻喉科;徐州医科大学附属宿迁医院南京鼓楼医院集团宿迁市人民医院麻醉科;
【分类号】：R726.1

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