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目的比较氯化琥珀胆碱与罗库溴铵复合丙泊酚、盐酸瑞芬太尼静脉全身麻醉的方法在支气管异物取出术中的优势。方法选择行支气管异物取出术的患儿900例,随机分为氯化琥珀胆碱组(A组)和罗库溴铵组(B组)。A组采用氯化琥珀胆碱,B组采用罗库溴铵,2组均复合丙泊酚、盐酸瑞芬太尼静脉全身麻醉;比较2组置入支气管镜和术毕插管的条件、脉搏血氧饱和度(SpO2)、心率(HR)、收缩压(SAP)的变化和术中咬肌紧张、支气管痉挛、术后呛咳的发生及对术后拔管的影响。结果 A组置入支气管镜、支气管镜经过隆突和术毕插管时SpO2、HR、SAP与麻醉前比较差异均有统计学意义(Pa<0.05,0.01)。B组术中、术后SpO2、HR和SAP与麻醉前比较差异均无统计学意义。B组咬肌紧张、支气管痉挛和术毕呛咳发生率与A组比较均明显减少(Pa<0.01)。B组予肌松药至置入支气管镜的时间、术毕拔管时间与A组比较差异均无统计学意义。B组置入支气管镜和术毕插管的条件(下颌松弛度)均优于A组(Pa<0.05)。结论罗库溴铵复合丙泊酚、盐酸瑞芬太尼静脉全身麻醉方法用于支气管异物取出术,麻醉诱导快,肌松条件好、代谢快,减少了术中、术后并发症的发生,提高了麻醉安全性。
Objective To compare the advantages of intravenous anesthesia with chlorpromazine and rocuronium in combination with propofol and remifentanil intravenous anesthesia in the removal of bronchial foreign bodies. Methods A total of 900 children with bronchial foreign body removal were randomly divided into group A (choline chloride) and group rocuronium (group B). Group A was treated with succinylcholine chloride, group B was treated with rocuronium, and both groups were given propofol and remifentanil intravenously under general anesthesia. The conditions of bronchoscopy and intraoperative cannulation were compared between the two groups. SpO2, heart rate (HR), systolic blood pressure (SAP) and intraoperative masseter muscle tension, bronchospasm, postoperative choking and its effect on postoperative extubation. Results A group of bronchoscope placed bronchoscopy, endoscopic bronchoscopy and operative intubation SpO2, HR, SAP compared with before anesthesia were statistically significant (Pa <0.05,0.01). There was no significant difference between the two groups in the postoperative SpO2, HR and SAP and before anesthesia. B group masseter muscle tension, bronchospasm and the incidence of postoperative cough compared with the A group were significantly reduced (Pa <0.01). B group to muscle relaxants into the bronchoscopy time, extubation time compared with the A group was no significant difference. The conditions (mandibular sag) in group B were better than those in group A (P <0.05). Conclusion The combination of rocuronium, propofol and remifentanil intravenous anesthesia for the removal of bronchial foreign body, induction of anesthesia, good muscle relaxation conditions, fast metabolism, reduce the incidence of intraoperative and postoperative complications, Improved anesthesia safety.