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医麻密切配合在小儿气道异物取出中的关键作用 被引量:2

医麻密切配合在小儿气道异物取出中的关键作用
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摘要 目的回顾14年小儿气道异物取出术105例的点滴经验,手术医师和麻醉师完美配合是手术成功的关键。准确诊断异物部位,麻醉及用药选择、手术步骤、手术时机等均应仔细研讨。方法小儿气道异物取出中,气管支气管异物大多用全麻:1)咪达唑仑异丙酚复合麻醉。2)异丙酚瑞芬太尼复合麻醉。3)氯胺酮γ-羟基丁酸钠复合麻醉;鼻道异物和咽、喉部异物用无麻或表麻。结果105例小儿气道异物中,气管支气管异物28例,咽、喉及声门区异物24例,鼻道异物53例,一次性取出96例,再次取出9例。无一例术中死亡。结论小儿气道异物应尽快取出,麻醉是关键,深度要足,若全麻深度不足比无麻更危险。要诊断准确,作好术前各项准备,手术时机正确把握。手术医师和麻醉师密切配合,共同预防术中并发症,正确选好异物钳,术者精心操作。预防呼吸和心跳骤停的并发症,及时发现异常征兆和正确处理,就能保证手术的成功。广泛宣传、普及卫生知识、改掉不良习惯,预防误吸异物,减少小儿气道异物的发生率。 Objective To explore the importance of the cooperation between operator and anesthetist during the removal of foreign body in children's airway. Methods General anesthesia were used in the removal of the tracheobronchial foreign body: midazolam plus diprivan, diprivan plus fentanyl and ketamine plus sodium y -hydroxybutyrate. Superficial anaesthesia, even without anaesthetic were used in the removal of the nasal, pharyngeal or laryngeal foreign body. Results There were 105 children with foreign body in the airway: 28 cases with foreign body in the trachea or bronchus, 24 cases with foreign body in the pharyngeal or laryngeal cavity and 53 cases with foreign body in the nasal cavity. Ninety-six cases were successfully cured without reoperation. Nine cases received the reoperation. There were no operative deaths. Conclusions Foreign body in children's airway should be remove as soon as possible. The key to success for this operation were the selection of efficient anesthesia, operative opportunity and preoperotive preparation. It was also important for the education about correct eating habits to avoid the foreign bodies breathed into children's airway.
作者 李国良
出处 《当代医学》 2009年第27期82-84,共3页 Contemporary Medicine
关键词 小儿气道异物取出 医麻配合 高频通气 the removal of foreign body in children's airway cooperation between operator and anesthetist high frequency ventilation
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