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目的比较单管喉罩通气与气管插管保留自主呼吸在小儿支气管异物取出术麻醉中的效果。方法将32例接受支气管异物取出术的患儿按照随机原则分为对照组和观察组,每组16例。观察组采取单管喉罩通气麻醉,对照组给予气管插管术实施麻醉;所有患儿均采用静脉预注咪唑安定并输注舒芬太尼和丙泊酚等药物进行麻醉诱导,术中使用七氟醚维持麻醉。比较两组患儿诱导前(T0)、插管/喉罩时(T1)、置镜时(T2)、钳取异物时(T3)和拔管/喉罩时(T4)血流动力学[收缩压(SBP)、舒张压(DBP)和心率(HR)]以及血氧饱和度(Sp O2)的变化,并比较两组患儿苏醒期并发症情况(如呛咳、屏气以及支气管痉挛等)。结果两组患儿在T0、T2和T3时刻的SBP、DBP和HR比较差异未见统计学意义(P均>0.05),而T1时刻观察组SBP、DBP和HR变化明显小于对照组,差异有统计学意义(P均<0.05);两组间各时刻Sp O2差异未见统计学意义(P均>0.05)。观察组苏醒期并发症明显少于对照组,差异有统计学意义(P<0.05)。结论小儿支气管异物取出术应用单管喉罩通气进行麻醉对患儿血流动力学影响较小,且能减少苏醒期并发症,值得在临床中推广应用。
Objective To compare the effect of single laryngeal mask ventilation and endotracheal intubation for spontaneous respiration in children with bronchial foreign body removal. Methods Thirty-two children who underwent bronchial foreign body removal were randomly divided into control group and observation group, 16 cases in each group. In the observation group, the anesthesia was performed with single-tube laryngeal mask ventilation and the control group with tracheal intubation. All the patients were given intravenous infusion of midazolam and infusion of drugs such as sufentanil and propofol for anesthesia induction. Intraoperatively Sevoflurane anesthesia. The hemodynamics were compared between pre-induction (T0), intubation / laryngeal mask (T1), at the time of mirroring (T2), foreign body clamp (T3) and extubation / Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR)] and oxygen saturation (Sp O2) were compared between the two groups, and the complication of awake (choking, breath holding and bronchospasm) ). Results There was no significant difference in SBP, DBP and HR between the two groups at T0, T2 and T3 (all P> 0.05), while the changes of SBP, DBP and HR at T1 were significantly lower than those of the control group Statistical significance (P <0.05). There was no significant difference in Sp O2 between the two groups at any time (P> 0.05). The observation group had significantly fewer complications during the recovery phase than the control group (P <0.05). Conclusion Removal of bronchial foreign body in children with single laryngeal mask ventilation anesthesia has little effect on hemodynamics in children, and can reduce the complications of recovery, it is worth promoting in clinical application.