国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2009年
5期
411-413,435
,共4页
食道闭锁%麻醉%七氟醚%呼吸管理
食道閉鎖%痳醉%七氟醚%呼吸管理
식도폐쇄%마취%칠불미%호흡관리
Esophageal atresia%Anesthesia%Sevoflurance%Respiratory management
目的 探讨合并有食管气管瘘的新生儿食道闭锁修补手术麻醉中的呼吸管理.方法 收集我院自2008年4月以来6例新生儿食道闭锁修补手术的麻醉记录,回顾其麻醉诱导和维持期的呼吸管理方法,分析麻醉期间不同时点的重要生命体征如心率、呼吸频率、PETCO2,SpO2和麻醉相关并发症.结果 6例患儿均采用了以七氟醚为主复合适当静脉麻醉药物的麻醉方法.在结扎气管食管瘘口前均保留了自主呼吸,所有患儿均能维持足够的通气,无一例患儿发生严重呼吸抑制和返流误吸.在麻醉诱导期,心率、呼吸频率、PETCO2和SpO2均平稳;开胸到结扎瘘口期间,心率、呼吸频率和PETCO2轻度升高;SpO2在轻度辅助通气下保持较好水平.结论 在新生儿食道闭锁修补手术从麻醉诱导到结扎气管食管瘘,采用七氟醚为主复合适当静脉麻醉药物,可以很好地保留自主呼吸,降低返流误吸.
目的 探討閤併有食管氣管瘺的新生兒食道閉鎖脩補手術痳醉中的呼吸管理.方法 收集我院自2008年4月以來6例新生兒食道閉鎖脩補手術的痳醉記錄,迴顧其痳醉誘導和維持期的呼吸管理方法,分析痳醉期間不同時點的重要生命體徵如心率、呼吸頻率、PETCO2,SpO2和痳醉相關併髮癥.結果 6例患兒均採用瞭以七氟醚為主複閤適噹靜脈痳醉藥物的痳醉方法.在結扎氣管食管瘺口前均保留瞭自主呼吸,所有患兒均能維持足夠的通氣,無一例患兒髮生嚴重呼吸抑製和返流誤吸.在痳醉誘導期,心率、呼吸頻率、PETCO2和SpO2均平穩;開胸到結扎瘺口期間,心率、呼吸頻率和PETCO2輕度升高;SpO2在輕度輔助通氣下保持較好水平.結論 在新生兒食道閉鎖脩補手術從痳醉誘導到結扎氣管食管瘺,採用七氟醚為主複閤適噹靜脈痳醉藥物,可以很好地保留自主呼吸,降低返流誤吸.
목적 탐토합병유식관기관루적신생인식도폐쇄수보수술마취중적호흡관리.방법 수집아원자2008년4월이래6례신생인식도폐쇄수보수술적마취기록,회고기마취유도화유지기적호흡관리방법,분석마취기간불동시점적중요생명체정여심솔、호흡빈솔、PETCO2,SpO2화마취상관병발증.결과 6례환인균채용료이칠불미위주복합괄당정맥마취약물적마취방법.재결찰기관식관루구전균보류료자주호흡,소유환인균능유지족구적통기,무일례환인발생엄중호흡억제화반류오흡.재마취유도기,심솔、호흡빈솔、PETCO2화SpO2균평은;개흉도결찰루구기간,심솔、호흡빈솔화PETCO2경도승고;SpO2재경도보조통기하보지교호수평.결론 재신생인식도폐쇄수보수술종마취유도도결찰기관식관루,채용칠불미위주복합괄당정맥마취약물,가이흔호지보류자주호흡,강저반류오흡.
Objective To study respiratory management during anesthesia for esophageal atresia repair in neonates.Methods Anesthesia records of six neonates who had tracheoesophageal astria repair in West China Hospital since april 2008 were reviewed.The respiratory management strategies for anesthesia induction and maintenance were collected.The vital signs including heart rate,breath rate,PETCO2 and SpO2 at various time points during anesthesia were analyzed and anesthesia related complications were reviewed.Results Sevoflurane-based anesthesia was used for induction and maintenance for all cases.Spontaneous breath was maintained until the ligation of fistula.All neonates were adequately ventilated,no severity respiratory depression and aspiration occurred in any cases.During the anesthesia induction,the heart rate,breathing rate,PETCO2 and Sp02 were stable.From chest opening to tracheoesophageal fistula ligation,the heart rate,PETCO2 and breathing rate were slightly increased while SpO2 was well maintained with gentle assisted ventilation.Conclusion Spontaneous breath can be easily maintained by using sevoflurane-based anesthesia up to the ligation of tracheoesophageal fistula for neonates undergoing tracheoesophageal astria repair,which may maintain an adequate ventilation while reducing the risk of aspiration.
