纤维支气管镜引导下气管插管在小儿鼾症麻醉中的应用-《中国微创外科杂志》

文章信息/Info

Title:: Application of Tracheal Intubation Guided by Fiberoptic Bronchoscopy in Children Snoring Disease Operation

作者:: 张剑伟; 唐东亮*①; 徐金; 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，宿迁223800

Author(s):: Zhang Jianwei*; Tang Dongliang; Xu Jin*.; *Department of Otolaryngology, Suqian People’s Hospital of Nanjing Drum Tower Hospital, Suqian Hospital Affiliated to Xuzhou Medical University, Suqian 223800, China

关键词:: 纤维支气管镜; 气管插管; 小儿; 鼾症

Keywords:: Fiberoptic bronchoscopy; Tracheal intubation; Children; Snoring disease

文献标志码:: A

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（P>0.05）。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:: ObjectiveTo explore the value of tracheal intubation guided by fiberoptic bronchoscopy in children snoring disease operation.MethodsA total of 50 patients underwent tracheal intubation guided by fiberoptic bronchoscope or laryngoscope from August 2015 to June 2016. There were 25 cases of fiberoptic bronchoscopy assigned into group A, 25 cases of laryngoscopy into group B. The intubation time, success rate and adverse reactions of the two groups were compared and analyzed.Results All the intubation in group A succeed at the first time. The intubation time was (20.1±4.3) s and the position was right. There was no need for replacement during the operation. Three cases in group B succeed at the second time because the tonsil was too big to expose the pharynx. The intubation got out of the pharynx in 3 cases in group B and were adjusted to the right position. The intubation time was (50.7±6.9) s and the success rate at the first time was 76% (19/25). Groups A behaved better than group B in aspects of the success rate of signal intubation and intubation time (Fisher’s Exact Test, P=0.022; t=-18.725, P=0.000). There were no adverse reactions in group A, such as pharyngorrhagia, odontoseisis or loss of tooth, laryngospasm and so on. There were 3 cases of hemorrhage from throat after intubation, 3 cases of loss of tooth in different degrees and 1 case of laryngospasm at second intubation time in group B. There was no significant difference in adverse reactions between the two groups (P>0.05).ConclusionFiberoptic bronchoscopy can be used for children snoring disease with good safety as well as rare adverse reactions.

参考文献/References:

[1]陆利君.小儿扁桃体、腺样体切除术的麻醉体会.广西医学，2009，31（11）：1740-1741.
[2]田崇明,桂长俊,姚梅,等.儿童阻塞性睡眠呼吸暂停低通气综合征的围手术期治疗.中国基层医药，2012，19（21）：3270-3271.
[3]庄心良，曾因明，陈伯銮.现代麻醉学.第3版.北京：人民卫生出版社，2011.989.
[4]许全珍. 新生儿纤维支气管镜运用的进展研究.中外医学研究，2013，11（12）：155-157.
[5]许和平,宋维.纤维支气管镜在48例困难气管插管急诊患者中的临床分析.中国急救医学，2015，35（7）:5-6.
[6]徐劲松，丁国友，来伟，等.支气管镜引导气管插管在麻醉气管困难插管的应用.临床肺科杂志，2009，14（3）：413.

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

文章信息/Info

参考文献/References:

备注/Memo

常用功能

导航/Navigate

工具/Tools

统计/Statistics