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婴儿经悬吊喉镜和Hopkins望远镜取出气管支气管异物

Removal of tracheobronchial foreign bodies via suspension laryngoscope and Hopkins telescope in infants.

作者信息

Lei Wen-bin, Su Zhen-zhong, Zhu Xiao-lin, Xiong Guan-xia, Chai Li-ping, Chen De-hua, Chen Feng-hong, Feng Xia, Liu Ke-xuan, Wen Wei-ping

机构信息

National Key Discipline of Otorhinolaryngology, Otorhinolaryngology Hospital, Otorhinolaryngology Institute Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.

出版信息

Ann Otol Rhinol Laryngol. 2011 Jul;120(7):484-8. doi: 10.1177/000348941112000711.

Abstract

OBJECTIVES

Tracheobronchial foreign body aspiration is a life-threatening accident in infants, and is still a formidable clinical emergency to both otorhinolaryngologists and anesthesiologists. In this study, we attempted to assess the safety and ease of tracheobronchial foreign body removal in infants via suspension laryngoscopy and Hopkins telescopy under general anesthesia with endotracheal intubation.

METHODS

The retrospective clinical study from 2006 to 2010 included 50 infants with foreign body aspiration, of whom 35 underwent suspension laryngoscopy and Hopkins telescopy and the other 15 underwent rigid bronchoscopy. All of the procedures were under general anesthesia with endotracheal intubation.

RESULTS

All of the patients underwent temporary extubation. The foreign body was successfully removed in 46 cases and was not found in the other 4 cases. The mean operation time in the rigid bronchoscopy group was 13.20+/-9.01 minutes, and that in the Hopkins telescopy group was 5.79+/-3.54 minutes. The oxygen saturation level was below 90% in 17 cases, of which 7 were in the rigid bronchoscopy group and 10 were in the Hopkins telescopy group. The vital signs, including the partial pressure of carbon dioxide in expiratory gas and the heart rate, were stable in all cases.

CONCLUSIONS

Foreign body removal in infants via suspension laryngoscopy and Hopkins telescopy under general anesthesia with endotracheal intubation should be promoted, since it is relatively safe and easy for both anesthesiologists and otorhinolaryngologists to perform and has a remarkable success rate.

摘要

目的

气管支气管异物吸入是婴幼儿危及生命的意外事件,对耳鼻咽喉科医生和麻醉医生来说仍是一个棘手的临床急症。在本研究中,我们试图评估在全身麻醉气管插管下,通过悬吊喉镜和Hopkins望远镜检查法取出婴幼儿气管支气管异物的安全性和便捷性。

方法

这项回顾性临床研究纳入了2006年至2010年期间50例有异物吸入的婴幼儿,其中35例接受了悬吊喉镜和Hopkins望远镜检查法,另外15例接受了硬质支气管镜检查。所有手术均在全身麻醉气管插管下进行。

结果

所有患者均进行了临时拔管。46例患者异物成功取出,4例未发现异物。硬质支气管镜检查组的平均手术时间为13.20±9.01分钟,Hopkins望远镜检查法组为5.79±3.54分钟。17例患者的血氧饱和度低于90%,其中7例在硬质支气管镜检查组,10例在Hopkins望远镜检查法组。所有病例的生命体征,包括呼气末二氧化碳分压和心率均稳定。

结论

应推广在全身麻醉气管插管下通过悬吊喉镜和Hopkins望远镜检查法取出婴幼儿异物的方法,因为对麻醉医生和耳鼻咽喉科医生来说,该方法相对安全、操作简便,且成功率高。

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