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目的比较七氟醚、丙泊酚和氯胺酮麻醉诱导用于小儿支气管镜检异物取出术的效果,评估其临床意义。方法选择2012年7月~2015年7月在本院行支气管镜异物取出术的患儿66例,采用随机数字表法将患儿分为三组:七氟醚组(A组),丙泊酚组(B组)和氯胺酮组(C组),对比三组患儿的手术时间、一次置镜成功率、麻醉诱导时间、苏醒时间的变化情况,并发症发生率和对比入室时、置镜前、置镜后、退镜时末梢血氧饱和度(Sp O2)、呼吸频率(RR)的变化情况等。结果 A组和B组成功置入气管镜的时间、术后苏醒时间明显短于C组(P<0.05);A组一次置管成功率明显高于C组(P<0.05)。三组患儿不良反应发生率差异无统计学意义。C组患儿在置镜后、退镜时Sp O2、RR与A组和B组相比明显降低(P<0.05)。结论与丙泊酚静脉注射和氯胺酮肌肉注射麻醉诱导比较,七氟醚诱导麻醉在婴幼儿气管镜检异物取出术中具有诱导快、苏醒快等优点,七氟醚能为支气管镜手术提供更好的操作条件。
Objective To compare the effects of sevoflurane, propofol and ketamine anesthesia induced bronchoscopy for the removal of foreign body to assess the clinical significance. Methods Sixty-six children with bronchoscopic foreign bodies removed from our hospital from July 2012 to July 2015 were randomly divided into three groups: sevoflurane group (group A), propofol (Group B) and ketamine group (group C). The operation time, the success rate of primary mirror, the time of anesthesia induction, the change of awakening time, complication incidence rate and contrast between the three groups were compared Before and after setting the mirror, the mirror when the peripheral oxygen saturation (Sp O2), respiratory rate (RR) changes and so on. Results The time of successful tracheoscope placement in group A and B was shorter than that in group C (P <0.05). The success rate of primary catheterization in group A was significantly higher than that in group C (P <0.05). There was no significant difference in the incidence of adverse reactions between the three groups. In group C, Sp O2 and RR were significantly lower than those in group A and group B (P <0.05). Conclusion Compared with intravenous injection of propofol and intramuscular injection of ketamine, sevoflurane-induced anesthesia has the advantages of rapid induction and rapid recovery in tracheal aspiration of infants and young children. Sevoflurane can provide better results for bronchoscopy Operating conditions.