中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2008年
12期
1956-1957
,共2页
支气管镜检查%气管异物%咪达唑仑%氯胺铜%丙泊酚
支氣管鏡檢查%氣管異物%咪達唑崙%氯胺銅%丙泊酚
지기관경검사%기관이물%미체서륜%록알동%병박분
Bmnchoscope%Intratracheal foreign body%Midazolam%Ketamine%Propofol
目的 观察和比较咪达唑仑复合丙泊酚用于小儿支气管镜检查及气管异物取出术的效果.方法 选择住院行支气管镜检查及异物取出术患儿60例,随机分为咪达唑仑-氯胺酮麻醉组(K组)和咪达唑仑-丙泊酚麻醉组(P组),每组各30例.每组均缓慢静脉注射咪达唑仑0.1～0.15 mg/kg,予面罩吸氧5～10min后,K组缓慢静脉注射氯胺酮2 mg/kg,置镜后视情况按1～2 mg/kg追加;P组缓慢静脉注射丙泊酚2 mg/kg,置镜后视情况按1～2 mg/kg追加.观察麻醉后术前、置镜时、术中、术后BP、HR、SpO2、RR、有无屏气、呛咳、术后喉水肿、舌后坠等情况.结果 两组患儿置镜前置镜后,MAP、HR、数值P组均显著低于K组(P＜0.05);P组置镜后MAP、HR均显著下降(P＜0.05),而K组HR不明显,MAP显著上升(P＜0.05);P组置镜后,RR较入室时显著下降(P＜0.05),且明显低于K组(P＜0.05);两组SpO2无差异.K组置镜时屏气、术中屏气,术后舌后坠、喉水肿、苏醒期屏气等并发症明显高于P组(P＜0.05),苏醒时间较P组明显延迟(P＜0.05).结论 咪达唑仑.丙泊酚用于小儿支气管镜检查及气管异物取出术优于咪达唑仑-氯胺酮麻醉效果.
目的 觀察和比較咪達唑崙複閤丙泊酚用于小兒支氣管鏡檢查及氣管異物取齣術的效果.方法 選擇住院行支氣管鏡檢查及異物取齣術患兒60例,隨機分為咪達唑崙-氯胺酮痳醉組(K組)和咪達唑崙-丙泊酚痳醉組(P組),每組各30例.每組均緩慢靜脈註射咪達唑崙0.1～0.15 mg/kg,予麵罩吸氧5～10min後,K組緩慢靜脈註射氯胺酮2 mg/kg,置鏡後視情況按1～2 mg/kg追加;P組緩慢靜脈註射丙泊酚2 mg/kg,置鏡後視情況按1～2 mg/kg追加.觀察痳醉後術前、置鏡時、術中、術後BP、HR、SpO2、RR、有無屏氣、嗆咳、術後喉水腫、舌後墜等情況.結果 兩組患兒置鏡前置鏡後,MAP、HR、數值P組均顯著低于K組(P＜0.05);P組置鏡後MAP、HR均顯著下降(P＜0.05),而K組HR不明顯,MAP顯著上升(P＜0.05);P組置鏡後,RR較入室時顯著下降(P＜0.05),且明顯低于K組(P＜0.05);兩組SpO2無差異.K組置鏡時屏氣、術中屏氣,術後舌後墜、喉水腫、囌醒期屏氣等併髮癥明顯高于P組(P＜0.05),囌醒時間較P組明顯延遲(P＜0.05).結論 咪達唑崙.丙泊酚用于小兒支氣管鏡檢查及氣管異物取齣術優于咪達唑崙-氯胺酮痳醉效果.
목적 관찰화비교미체서륜복합병박분용우소인지기관경검사급기관이물취출술적효과.방법 선택주원행지기관경검사급이물취출술환인60례,수궤분위미체서륜-록알동마취조(K조)화미체서륜-병박분마취조(P조),매조각30례.매조균완만정맥주사미체서륜0.1～0.15 mg/kg,여면조흡양5～10min후,K조완만정맥주사록알동2 mg/kg,치경후시정황안1～2 mg/kg추가;P조완만정맥주사병박분2 mg/kg,치경후시정황안1～2 mg/kg추가.관찰마취후술전、치경시、술중、술후BP、HR、SpO2、RR、유무병기、창해、술후후수종、설후추등정황.결과 량조환인치경전치경후,MAP、HR、수치P조균현저저우K조(P＜0.05);P조치경후MAP、HR균현저하강(P＜0.05),이K조HR불명현,MAP현저상승(P＜0.05);P조치경후,RR교입실시현저하강(P＜0.05),차명현저우K조(P＜0.05);량조SpO2무차이.K조치경시병기、술중병기,술후설후추、후수종、소성기병기등병발증명현고우P조(P＜0.05),소성시간교P조명현연지(P＜0.05).결론 미체서륜.병박분용우소인지기관경검사급기관이물취출술우우미체서륜-록알동마취효과.
Objective To observe and compare the anesthesia effect of propofol combined with midazolam used in the bronchoscopes and the removal of children's intratraeheal foreign body.Methods 60 patients in hospital were choser to do the operation of bronchoscopes and the removal of children's intratracheal foreign body,the patients of selective operation were randomized into K group(n=30)related to midazolam-ketamine and P group(n=30)related to midazolam-propofol.The patients were respectively injected midazolam slowly given in a dose of 0.1～0.15mg/kg,and then offer oxygen 5～10 minutes with a face mask.After that the patients in group K were injected ketamine slowly in the dose of 2mg/kg,and 1～2mg/kg after laying the bronchoscope according as ease.The patients in group P were injected propofol slowly in the dose of 2mg/kg also,add 1～2mg/kg according as case.Observing the patients' BP,HR,SpO2,RR and if or not holding breath,bucking,postoperation laryngeal edema,glossocoma at the different periods:preoperation,laying the bronehoscope,during the operation and after the operation.Results To compare the two groups,the MAP,HR of group P are lower obviously than group K before and after laying the bmnchoscope(P＜0.05).The HR,MAP of groug P descended significantly after laying bronchoscope(P＜0.05),while the HR fluctuate little but MAP ascend significantly in the group K(P＜0.05).After laying bronchoscope the RR descend significantly than that when patients entered operation room(P＜0.05),and also lower than that ofgroup K(P＜0.05).The SpO2 in the two groups have no difference.The complications as holding breath,postoperative glossocema,laryngeal edema,holding breath during reviving time,in the group K happened at a high rate than the group P(P＜0.05),the awaking time is also longer in the former(P＜0.05).Conclusion The anesthesia effect of midazolam-propofol is superior to that of midazdam-ketamine in the removal of children's intratraeheal foreign body.
