中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
15期
4-7
,共4页
魏宁%刘金%徐浩%祖茂衡%顾玉明
魏寧%劉金%徐浩%祖茂衡%顧玉明
위저%류금%서호%조무형%고옥명
气管支架%实验犬%雾化吸入%麻醉
氣管支架%實驗犬%霧化吸入%痳醉
기관지가%실험견%무화흡입%마취
Tracheal stenosis%Experimental dogs%Aerosol inhalation%Anesthesia
目的探讨实验犬经口气管支架置入术中3种不同麻醉方案的应用。方法9只实验犬随机分为3组，A组(n=3)院单纯采用地西泮稀释液(10~15 mg/kg)腹腔注射麻醉；B组(n=3)院地西泮稀释液麻醉实验犬后，经口置入4F单弯导管于犬气管壁表面，由上至下旋转状态中缓慢推注2%盐酸利多卡因2~3 ml局部麻醉；C组(n=3)院地西泮稀释液麻醉后面罩雾化吸入盐酸氨溴索30 mg+2%盐酸利多卡因5 ml+地塞米松5 mg+生理盐水10 ml混合液15 min。各组麻醉完成后行气管支架置入，采用心电监护仪监测各组实验犬血氧饱和度，并记录实验曝光时间，通过DSA-3D评估支架释放位置。结果共置入气管支架9枚，A组3例支架置入过程困难，反复操作9次，其中1例支架下移并导致实验犬术后24 h内死亡；B组3例支架置入较为困难，共操作5次，其中1例支架释放位置偏上；C组3例支架置入均一次性成功，且支架在位良好。A组术中血氧饱和度较术前明显下降，差异有统计学意义[(73.50±16.12)%v s (98.83±1.17)%，P<0.05]，实验犬严重躁动；B组术中血氧饱和度较术前有所下降，但差异无统计学意义[(92.67±3.32)% vs(98.83±1.17)%，P>0.05]，实验犬躁动减少；C组术中血氧饱和度较术前基本正常[(94.67±2.66)% vs(99.17±0.75)%，P>0.05]，实验犬无明显躁动。 A、B、C组曝光时间分别为(27.00±5.02)、(12.50±1.87)、(7.50±1.04)min，三组间比较差异有统计学意义(P<0.05)，其中A组曝光时间最长，C组曝光时间最短。结论实验犬经口放置气管支架具有较强的可行性和可重复性，地西泮稀释液腹腔注射麻醉结合雾化吸入麻醉混合剂在气管支架置入过程中反应最小，有助于提高手术成功率，减少术中曝光时间。
目的探討實驗犬經口氣管支架置入術中3種不同痳醉方案的應用。方法9隻實驗犬隨機分為3組，A組(n=3)院單純採用地西泮稀釋液(10~15 mg/kg)腹腔註射痳醉；B組(n=3)院地西泮稀釋液痳醉實驗犬後，經口置入4F單彎導管于犬氣管壁錶麵，由上至下鏇轉狀態中緩慢推註2%鹽痠利多卡因2~3 ml跼部痳醉；C組(n=3)院地西泮稀釋液痳醉後麵罩霧化吸入鹽痠氨溴索30 mg+2%鹽痠利多卡因5 ml+地塞米鬆5 mg+生理鹽水10 ml混閤液15 min。各組痳醉完成後行氣管支架置入，採用心電鑑護儀鑑測各組實驗犬血氧飽和度，併記錄實驗曝光時間，通過DSA-3D評估支架釋放位置。結果共置入氣管支架9枚，A組3例支架置入過程睏難，反複操作9次，其中1例支架下移併導緻實驗犬術後24 h內死亡；B組3例支架置入較為睏難，共操作5次，其中1例支架釋放位置偏上；C組3例支架置入均一次性成功，且支架在位良好。A組術中血氧飽和度較術前明顯下降，差異有統計學意義[(73.50±16.12)%v s (98.83±1.17)%，P<0.05]，實驗犬嚴重躁動；B組術中血氧飽和度較術前有所下降，但差異無統計學意義[(92.67±3.32)% vs(98.83±1.17)%，P>0.05]，實驗犬躁動減少；C組術中血氧飽和度較術前基本正常[(94.67±2.66)% vs(99.17±0.75)%，P>0.05]，實驗犬無明顯躁動。 A、B、C組曝光時間分彆為(27.00±5.02)、(12.50±1.87)、(7.50±1.04)min，三組間比較差異有統計學意義(P<0.05)，其中A組曝光時間最長，C組曝光時間最短。結論實驗犬經口放置氣管支架具有較彊的可行性和可重複性，地西泮稀釋液腹腔註射痳醉結閤霧化吸入痳醉混閤劑在氣管支架置入過程中反應最小，有助于提高手術成功率，減少術中曝光時間。
목적탐토실험견경구기관지가치입술중3충불동마취방안적응용。방법9지실험견수궤분위3조，A조(n=3)원단순채용지서반희석액(10~15 mg/kg)복강주사마취；B조(n=3)원지서반희석액마취실험견후，경구치입4F단만도관우견기관벽표면，유상지하선전상태중완만추주2%염산리다잡인2~3 ml국부마취；C조(n=3)원지서반희석액마취후면조무화흡입염산안추색30 mg+2%염산리다잡인5 ml+지새미송5 mg+생리염수10 ml혼합액15 min。각조마취완성후행기관지가치입，채용심전감호의감측각조실험견혈양포화도，병기록실험폭광시간，통과DSA-3D평고지가석방위치。결과공치입기관지가9매，A조3례지가치입과정곤난，반복조작9차，기중1례지가하이병도치실험견술후24 h내사망；B조3례지가치입교위곤난，공조작5차，기중1례지가석방위치편상；C조3례지가치입균일차성성공，차지가재위량호。A조술중혈양포화도교술전명현하강，차이유통계학의의[(73.50±16.12)%v s (98.83±1.17)%，P<0.05]，실험견엄중조동；B조술중혈양포화도교술전유소하강，단차이무통계학의의[(92.67±3.32)% vs(98.83±1.17)%，P>0.05]，실험견조동감소；C조술중혈양포화도교술전기본정상[(94.67±2.66)% vs(99.17±0.75)%，P>0.05]，실험견무명현조동。 A、B、C조폭광시간분별위(27.00±5.02)、(12.50±1.87)、(7.50±1.04)min，삼조간비교차이유통계학의의(P<0.05)，기중A조폭광시간최장，C조폭광시간최단。결론실험견경구방치기관지가구유교강적가행성화가중복성，지서반희석액복강주사마취결합무화흡입마취혼합제재기관지가치입과정중반응최소，유조우제고수술성공솔，감소술중폭광시간。
Objective To investigate application on three different anesthesia scheme in the breath tube carotid stenting in experimental dogs. Methods 9 experimental dogs were randomly divided into three groups,group A (n=3):the dogs were anesthesia through intraperitoneal injection with Diazepam Diluents (10-15 mg/kg);group B (n=3):the trachea of dogs were topically anesthesia through slowly pushing 2% Lidocaine Hydrochloride Injection (2-3 ml) with 4F VER catheter after anesthesia with Diazepam Diluents;group C (n=3):the dogs were took the aerosol inhalation with the mix-ture of anesthesia (Ambroxol Hydrochloride 30 mg+2% Lidocaine Hydrochloride 5 ml+ Dexamethasone 5 mg+Normal saline 10 ml) for 15 minutes after anesthesia with Diazepam Diluents.All tracheal stent were implanted for experimental dogs after anesthesia.The blood oxygen saturation and the exposure time were recorded by electrocardiogram monitoring. Position of the stent was evaluated by DSA-3D. Results A total of 9 tracheal stents were implanted, the procedure of tracheal stent implantation in 3 cases was difficult in group A, and was repeated for 9 times,finally, 1 dog died after stent displacement within 24 h;3 stents of group B were relatively difficultly implanted in tracheal,stent was released in upper position in 1 case after operating for 5 times;tra-cheal stents implantation in 3 cases were success of disposable in group C, and the stents were in place well.Blood oxygen saturation during operation de-creased more obviously in preoperative in group A with statistically significant difference [(73.50±16.12)%v s (98.83±1.17)%,P<0.05],and the the experimental dogs were restless severely;blood oxygen saturation during operation decreased in preoperative in group B without statistical-ly significant difference [(92.67±3.32)%v s (98.83±1.17)%,P>0.05], but the restlessness of the experimental dogs were lower than group A;blood oxygen saturation during operation obviously was normal with preoperative in group C [(94.67±2.66)% v s (99.17±0.75)%,P>0.05], and there was no obvious restless for the experimental dogs.The exposure time in group A,B,C was (27.00±5.02),(12.50±1.87),(7.50±1.04) min, respectively,comparative difference between three groups was statistically significant (P<0.05), and group A had the longest exposure time,group C had the shortest expo-sure time. Conclusion The experimental dogs oral tracheal stent placement has strong feasibility and repeatability, the adverse reactions are minimum after Diazepam dilution is used for intraperitoneal injection of anesthesia combined with inhalation anesthetic mixture in the process of tracheal stent implantation, which is helpful to improve the success rate of surgery and to reduce intraoperative exposure time.
