CAJ | 학술논문

目的：观察加强型气管导管在小儿支撑喉镜下声带息肉摘除术中的应用，为临床麻醉安全提供经验。方法选择气管插管全身麻醉下行支撑喉镜下声带息肉摘除术的患儿60例，按照抽签法将患儿随机均分为加强型气管导管组（A组）和普通型气管导管组（B组），每组30例。分别记录两组插管前及插管后2min心率及平均动脉压（MAP），术中气道阻力、动脉血氧饱和度（SpO2）、呼吸末二氧化碳分压（PetCO2）的变化以及插管时间、一次插管成功率、导管折叠和移位发生率。结果A组与B组插管前及插管后2min心率及MAP比较，差异均无统计学意义（P.0.05）。A组患儿术中气道阻力低于B组〔（13.1±1.2）cmH2O与（18.3±1.7）cmH2O，P<0.05〕；两组患儿术中SpO2、PetCO2比较，差异均无统计学意义（P.0.05）。术中A组无一例患儿出现气道梗阻，而B组有5例患儿出现气道梗阻。两组插管时间比较，差异无统计学意义（P.0.05）；A组一次插管成功率高于B组〔28（93.3%）与24（80.0%）〕，导管折叠和移位发生率低于B组〔0与7（23.3%）〕（P<0.05）。结论选用加强型气管导管可明显提高气管插管一次成功率，同时减少术中导管折叠和移位的发生率，避免气道梗阻发生，更适合小儿全身麻醉支撑喉镜下声带息肉摘除术的需要。
목적：관찰가강형기관도관재소인지탱후경하성대식육적제술중적응용，위림상마취안전제공경험。방법선택기관삽관전신마취하행지탱후경하성대식육적제술적환인60례，안조추첨법장환인수궤균분위가강형기관도관조（A조）화보통형기관도관조（B조），매조30례。분별기록량조삽관전급삽관후2min심솔급평균동맥압（MAP），술중기도조력、동맥혈양포화도（SpO2）、호흡말이양화탄분압（PetCO2）적변화이급삽관시간、일차삽관성공솔、도관절첩화이위발생솔。결과A조여B조삽관전급삽관후2min심솔급MAP비교，차이균무통계학의의（P.0.05）。A조환인술중기도조력저우B조〔（13.1±1.2）cmH2O여（18.3±1.7）cmH2O，P<0.05〕；량조환인술중SpO2、PetCO2비교，차이균무통계학의의（P.0.05）。술중A조무일례환인출현기도경조，이B조유5례환인출현기도경조。량조삽관시간비교，차이무통계학의의（P.0.05）；A조일차삽관성공솔고우B조〔28（93.3%）여24（80.0%）〕，도관절첩화이위발생솔저우B조〔0여7（23.3%）〕（P<0.05）。결론선용가강형기관도관가명현제고기관삽관일차성공솔，동시감소술중도관절첩화이위적발생솔，피면기도경조발생，경괄합소인전신마취지탱후경하성대식육적제술적수요。
Objective To study the application of reinforced tracheal catheter in vocal cord polypectomy under pediat-ric laryngoscope in order to provide reference for clinical anesthesia. Methods 60 children under general anesthesia with endotra-cheal intubation for vocal polypectomy under laryngoscope were randomly divided into reinforced tracheal catheter group ( group A)and normal endotracheal intubation group( group B),with each group 30 cases. The intubation time,success rate of intuba-tion,HR,mean arterial pressure( MAP)before intubation and 2 min after intubation were recorded. At the same time,the air-way resistance,SpO2 ,PetCO2 ,intubation time,successful rate of intubation and the rate of catheter folding and displacement between two groups of children during the operations were recorded. Results The HR and MAP before intubation and 2 min after intubation between group A and group B showed no statistically significant difference(P .0. 05). The airway resistance in group A was lower than in group B〔(13. 1 ± 1. 2) cm H2 O vs. (18. 3 ± 1. 7) cm H2 O,P<0. 05〕. The SpO2 and PetCO2 during op-eration between the two groups showed no statistically significant difference(P .0. 05). No case in group A had airway obstruc-tion,while 5 cases had airway obstruction in group B. The intubation time between the two groups showed no statistically signifi-cant difference(P . 0. 05). The successful rate of intubation in group A was higher than in group B〔28(93. 3%)vs. 24 (80. 0%)〕,but the rate of catheter folding and displacement were lower in group A than in group B〔0 vs. 7(23. 3%)〕(P<0. 05 ) . Conclusion Application of reinforced tracheal tube in vocal polypectomy under laryngoscope can obviously increase the success rate of tracheal intubation,reduce the rate of catheter folding,displacement and avoid the airway obstruction,making it more suitable for this kind of operations.