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1、全麻下高頻噴射通氣在小兒氣道異物取出術(shù)的應(yīng)用【關(guān)鍵詞】高頻 摘要:目的:觀察靜脈復(fù)合全麻下高頻噴射通氣(HFJV)在小兒氣道異物取出術(shù)的臨床效果。方法:患兒在進(jìn)入手術(shù)室前肌注氯胺酮4~8mg/kg,待患兒安靜入睡后進(jìn)手術(shù)室,開通靜脈通道后緩慢注射羥丁酸鈉(r-OH)80~100mg/kg,約10min后以1%地卡因作喉部表面霧化噴入,較大患兒于環(huán)甲膜穿刺注入1%地卡因1ml,5min后即可手術(shù),手術(shù)時間超過90min者,可追加氯胺酮、r-OH等。術(shù)中HFJV采用國產(chǎn)KR-Ⅱ呼吸機(jī),電控氣動進(jìn)行噴射通氣,頻率根據(jù)缺氧程度選用1
2、44~200次/min,氣源驅(qū)動壓0.6~1.2kg/cm2。結(jié)果:術(shù)中麻醉平穩(wěn)、缺O(jiān)2改善,52例氣管、支氣管異物的患兒在靜脈復(fù)合全麻下行高頻噴射通氣均順利完成手術(shù)。結(jié)論:靜脈復(fù)合全麻下行HFJV在小兒氣道異物取出術(shù)的應(yīng)用效果是確切的?! £P(guān)鍵詞:高頻噴射通氣;小兒;氣管異物取出 TheApplicationofGeneralAnesthesiaHigh-frequencyJetVentilation intheInfantileAirPassageForeignBodyExtraction Abstract:Obje
3、ctive:ToobservetheclinicaleffectoftheHFJVundergeneralintravenouscombinedanesthesiaintheinfantileairpassageforeignbodyextraction.Method:Beforeenteringtheoperatingroom,theinfantpatientwasinjectedwithketamineof4~8mg/kg.Thenthesleepinginfantpatientwassenttotheoperatingr
4、oom,andther-OHof80~100mg/kgwasslowlyinjectedaftertheintravenoustrackwasreadythere.10minuteslater,the1%dicainewassprayednebulizationallyviathethroat,andforthebiggerinfant,1%dicaineof1mlwasinjectedbyintercricocentesis.Andtheoperationwasconducted5minuteslater.Forthepat
5、ientswhoseoperationtimeexceeded90minutes,theketamineandr-OHwouldhavebeenaddedforthesecondtime.Duringtheoperation,thedomesticKR-IIrespiratorandelectric-controlpneumaticmethodwereusedforjetventilationwiththefrequencyof144~200times/aminutechosenupontheoxygenlacklevelan
6、dtheairsourcedrivingpressurebeing0.6~1.2kg/cm2.Result:Duringtheoperation,theanesthesiawasstableandtheoxygenlacklevelhadbeenimproved.The52casesofoperationofinfantswithforeignbodiesintracheaorbronchuswerecompletedsmoothlybytheHFJVunderthecompleteintravenouscombinedane
7、sthesia.Conclusion:TheapplicationofcompleteintravenouscombinedanesthesiaHFJViseffectiveintheinfantileairpassageforeignbodyextraction.3 Keywords:High-frequencyjetventilation;Infant;Airpassageforeignbodyextraction 我院自2001年1月至2004年6月,在全麻下采用國產(chǎn)KR-Ⅱ型高頻噴射通氣(HFJV)呼吸機(jī)在52例小
8、兒氣管、支氣管異物取出術(shù)中的應(yīng)用,取得較好的臨床效果,現(xiàn)報告如下: 1資料與方法 1.1臨床資料:本組52例,男32例,女20例。氣管異物15例,支氣管異物37例。年齡9個月至1歲10例,1歲以上至2歲25例,2歲以上至5歲13例,9歲2例。中度缺O(jiān)214例,嚴(yán)重缺O(jiān)23