摘要
目的 :探讨先天性食管闭锁伴气管食管瘘手术的麻醉方法及呼吸管理。方法 :回顾性分析 9例先天性食管闭锁伴气管食管瘘手术的麻醉处理过程。结果 :7例采取了慢诱导气管内插管保留自主呼吸、气管食管瘘管钳闭后完全控制呼吸管理病例手术过程中生命体征平稳 ;术后胸片显示 ,无明显肺不张及肺炎加重。 2例快诱导病例 :诱导时出现胃胀气 ,气道阻力逐渐增加 ;术后胸片显示 :肺炎加重并出现肺不张。 9例术中保暖好无体温不升。 7例治愈出院 ;2例家属放弃治疗。结论 :先天性食管闭锁伴气管食管瘘手术采用慢诱导气管内插管保留自主呼吸与气管食管瘘管钳闭后完全控制呼吸相结合的全身麻醉 ,能有效减少肺部并发症发生 ,且麻醉诱导维持稳定。
Objective:To probe the anesthesia methods and management of respiration in the operation on congenital esophageal atresia accompanying tracheo-esophageal fistula.Methods:Retrospective analysis was used to study anesthesia process during operation of 9 cases.Results:Vital signs of 7 cases during operation were stable.No increased airway resistance or bronchospasm was observed.Seven patients who received endotracheal intubation and controlled respiration after slow induction developed no significant atelectasis or more severe pneumonia on post -operation X-ray.Stomach gassiness happened in two patients who received fast induction.Gradually increased airway resistance was observed and more severe pneumonia accompanying atelectasis happened in the two patients.No hypothermia happened among these 9 patients owning to right keeping warm.Seven patients were discharged in good health.The families of two patients gave up treatment.Conclusion:Pulmonary complication can be reduced effectively and the same stable anesthesia can be obtained by combining the existing autonomous breath after slow induction with controlled breath after blocking up fistula cannula.The effective aspiration,keeping warm, intensive transfusion and consummate analgesia during and after the operation are very important to guarantee the security for patients.
出处
《重庆医科大学学报》
CAS
CSCD
2004年第5期682-683,695,共3页
Journal of Chongqing Medical University
关键词
先天性食管闭锁
气管食管瘘
麻醉
新生儿
Congenital esophageal atresia
Tracheo-esophageal fistula
Anesthesia
Infant
