中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2014年
11期
700-702
,共3页
王永军%石永生%李晗怡%张新梅
王永軍%石永生%李晗怡%張新梅
왕영군%석영생%리함이%장신매
支气管镜检查%儿童%气管异物%麻醉
支氣管鏡檢查%兒童%氣管異物%痳醉
지기관경검사%인동%기관이물%마취
Bronchoscopy%Children%Tracheobronchial foreign body%Anesthesia
目的 探讨两种麻醉方式对于儿童支气管异物取出的临床疗效.方法 回顾性研究甘肃省妇幼保健院自2010年9月至2013年7月经软式支气管镜行异物取出术的56例住院患儿,均明确诊断为气管-支气管异物,年龄8个月～11岁,男32例,女24例;深度镇静麻醉30例,全身麻醉26例,对比两种麻醉方式的临床效果.结果 深度镇静麻醉组和全身麻醉组异物取出成功率分别为83.33％和96.15％ (P＞ 0.05),两组在血氧饱和度下降(86.67％ vs 92.31％)、发绀(30.00％ vs26.92％)、出血(16.67％ vs 15.38％)、发热(6.67％ vs3.85％)、声音嘶哑(40.00％ vs 34.62％)、呕吐(26.67％ vs 19.23％)等并发症几率方面差异无统计学意义(P均＞0.05);全身麻醉组出现呛咳(11.54％ vs 93.33％)及抵抗(0 vs 73.33％)的几率明显小于深度镇静麻醉组,两组比较差异均有统计学意义(P均＜0.05).与深度镇静麻醉组患儿比较,全身麻醉组患儿的平均住院费用高[(4 050.25±1 176.75)元Vs(4 718.73±1 02.61)元],平均麻醉准备时间长[(6.50±1.70) rmin vs(18.54±3.46)min],但平均取异物时间短[(39.52±15.68) min vs(13.32±6.38) min],两组比较差异均有统计学意义(P均＜0.05),而平均住院天数[(5.67±1.65) dvs (5.46±1.65)d]差异无统计学意义(P＞0.05).结论 全身麻醉异物取出成功率高,在取异物时间、患儿舒适度等方面有明显改善,但平均住院费用、平均麻醉准备时间要多于深度镇静麻醉.
目的 探討兩種痳醉方式對于兒童支氣管異物取齣的臨床療效.方法 迴顧性研究甘肅省婦幼保健院自2010年9月至2013年7月經軟式支氣管鏡行異物取齣術的56例住院患兒,均明確診斷為氣管-支氣管異物,年齡8箇月～11歲,男32例,女24例;深度鎮靜痳醉30例,全身痳醉26例,對比兩種痳醉方式的臨床效果.結果 深度鎮靜痳醉組和全身痳醉組異物取齣成功率分彆為83.33％和96.15％ (P＞ 0.05),兩組在血氧飽和度下降(86.67％ vs 92.31％)、髮紺(30.00％ vs26.92％)、齣血(16.67％ vs 15.38％)、髮熱(6.67％ vs3.85％)、聲音嘶啞(40.00％ vs 34.62％)、嘔吐(26.67％ vs 19.23％)等併髮癥幾率方麵差異無統計學意義(P均＞0.05);全身痳醉組齣現嗆咳(11.54％ vs 93.33％)及牴抗(0 vs 73.33％)的幾率明顯小于深度鎮靜痳醉組,兩組比較差異均有統計學意義(P均＜0.05).與深度鎮靜痳醉組患兒比較,全身痳醉組患兒的平均住院費用高[(4 050.25±1 176.75)元Vs(4 718.73±1 02.61)元],平均痳醉準備時間長[(6.50±1.70) rmin vs(18.54±3.46)min],但平均取異物時間短[(39.52±15.68) min vs(13.32±6.38) min],兩組比較差異均有統計學意義(P均＜0.05),而平均住院天數[(5.67±1.65) dvs (5.46±1.65)d]差異無統計學意義(P＞0.05).結論 全身痳醉異物取齣成功率高,在取異物時間、患兒舒適度等方麵有明顯改善,但平均住院費用、平均痳醉準備時間要多于深度鎮靜痳醉.
목적 탐토량충마취방식대우인동지기관이물취출적림상료효.방법 회고성연구감숙성부유보건원자2010년9월지2013년7월경연식지기관경행이물취출술적56례주원환인,균명학진단위기관-지기관이물,년령8개월～11세,남32례,녀24례;심도진정마취30례,전신마취26례,대비량충마취방식적림상효과.결과 심도진정마취조화전신마취조이물취출성공솔분별위83.33％화96.15％ (P＞ 0.05),량조재혈양포화도하강(86.67％ vs 92.31％)、발감(30.00％ vs26.92％)、출혈(16.67％ vs 15.38％)、발열(6.67％ vs3.85％)、성음시아(40.00％ vs 34.62％)、구토(26.67％ vs 19.23％)등병발증궤솔방면차이무통계학의의(P균＞0.05);전신마취조출현창해(11.54％ vs 93.33％)급저항(0 vs 73.33％)적궤솔명현소우심도진정마취조,량조비교차이균유통계학의의(P균＜0.05).여심도진정마취조환인비교,전신마취조환인적평균주원비용고[(4 050.25±1 176.75)원Vs(4 718.73±1 02.61)원],평균마취준비시간장[(6.50±1.70) rmin vs(18.54±3.46)min],단평균취이물시간단[(39.52±15.68) min vs(13.32±6.38) min],량조비교차이균유통계학의의(P균＜0.05),이평균주원천수[(5.67±1.65) dvs (5.46±1.65)d]차이무통계학의의(P＞0.05).결론 전신마취이물취출성공솔고,재취이물시간、환인서괄도등방면유명현개선,단평균주원비용、평균마취준비시간요다우심도진정마취.
Objective To investigate the clinical effect of two different anaesthesia methods in removing the tracheobronchial foreign bodies in children.Methods This was a retrospective study with 56 hospitalized children through fiberoptic bronchoscope foreign body removing since September 2010 to July 2013 in Gansu Provincial Maternity and Child-Care Hospital.All of the children whose age from 8 months to 11 years were diagnosed of tracheal-bronchial foreign body.Among 56 cases,30 cases were operated with deep sedation anesthesia(deep sedation anesthesia group),and 26 cases with general anesthesia(general anesthesia group).The clinical effect of the two kinds of anesthesia were compared.Results The success rate of foreign bodies in deep sedation anesthesia group and general anesthesia group were 83.33％ and 96.15％ respectively (P ＞ 0.05),there were no statistical differences in oxygen desaturation (86.67 ％ vs 92.31％),cyanosis(30.00％ vs 26.92％),bleeding (16.67％ vs 15.38％),fever (6.67％ vs 3.85％),voice hoarse (40.00％ vs 34.62％),vomiting (26.67 ％ vs 19.23 ％),and other complications between two groups (P ＞ 0.05,respectively).There were significant differences in the rate of choking cough(11.54％ vs 93.33％) and resistance (0 vs 73.33％) between general anesthesia group and deep sedation anesthesia group (P ＜ 0.05).Compared with the deep sedation anesthesia group,the average hospitalization cost[(4 718.73 ± 1 012.61) (￥) vs (4 050.25 ± 1 176.75) (￥)] was bigger,and the average setup time [(18.54 ± 3.46) min vs (6.50-± 1.70) min] was longer,but the average removal of foreign body time [(13.32 ± 6.38) min vs (39.52 ± 15.68) min] was smaller in general anesthesia group,there were significant differences between two groups(P ＜ 0.05,respectively),while there was no statistical difference in the average hospitalization days [(5.46 ± 1.65) d vs (5.67 ± 1.65) d] between two groups (P ＞ 0.05).Conclusion Compared with the deep sedation anesthesia,the success rate of removal foreign bodies is higher,and the removal foreign body time as well as comfort are all significantly improved through general anesthesia,but the average hospitalization cost and average preparation time of general anesthesia are bigger than those of deep sedation anesthesia.
