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目的:观察静脉复合全麻下高频喷射通气(HFJV)在小儿气道异物取出术的临床效果。方法:患儿在进入手术室前肌注氯胺酮4～8mg/kg,待患儿安静入睡后进手术室,开通静脉通道后缓慢注射羟丁酸钠(r-OH)80～100mg/kg,约10min后以1%地卡因作喉部表面雾化喷入,较大患儿于环甲膜穿刺注入1%地卡因1ml,5min后即可手术,手术时间超过90min者,可追加氯胺酮、r-OH等。术中HFJV采用国产KR-Ⅱ呼吸机,电控气动进行喷射通气,频率根据缺氧程度选用144～200次/min,气源驱动压0.6～1.2kg/cm2。结果:术中麻醉平稳、缺O2改善,52例气管、支气管异物的患儿在静脉复合全麻下行高频喷射通气均顺利完成手术。结论:静脉复合全麻下行HFJV在小儿气道异物取出术的应用效果是确切的。
Objective: To observe the clinical effect of high frequency jet ventilation (HFJV) in pediatric airway foreign body removal under general anesthesia. Methods: Children received intramuscular injection of ketamine 4 ~ 8mg / kg before entering the operating room. After the patients were asleep, they were admitted into the operating room. After the intravenous access was started, sodium oxybate (80 ~ 100mg / kg) After injection of 1% dexamethasone on the surface of the throat, larger children injected 1% tetracaine on 1% dexamethasone for 5 minutes and then operated for more than 90 minutes to recover ketamine, r -OH and so on. Intraoperative HFJV using domestic KR-Ⅱ ventilator, electronically controlled pneumatic jet ventilation, the frequency of selection based on the degree of hypoxia 144 ~ 200 times / min, the gas source driving pressure 0.6 ~ 1.2kg / cm2. Results: Intraoperative anesthesia was stable, lack of improvement of O2, 52 cases of tracheobronchial foreign bodies in children undergoing intravenous combined anesthesia under high-frequency jet ventilation were successfully completed surgery. Conclusion: The effect of HFJV in the removal of pediatric airway foreign body by intravenous combined general anesthesia is definite.