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全麻下取气管异物48例临床分析 |
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赵绯 杨晖
摘 要：目的 提高全麻下取气管异物安全性和成功率的再认识，正确选择其适应证和方法。方法 按病史长短、异物性质及部位，统计10年全麻下取气管异物48例。结果 占同期气管异物的0.85%，病史2天至1年，31例在1个月以上，4例1年以上。按性质分类：化学性异物14例，植物性异物28例，金属性异物6例。按部位分类：正气管3例，左支气管20例，右支气管25例。48例中取出异物45例，未取出3例。结论 特殊复杂异物在全麻下取出极其安全，临床上要正确选择全麻下取气管异物的适应证及其方法。
关键词：全身麻醉 气管异物 适应证
An analysis of 48 cases foreign bodies removal from the trachea under general anesthesia
Zhao Fei
(Beijing Children Hospital of Capital Medical University, Beijing 100045)
Yang Hui
(Beijing Children Hospital of Capital Medical University, Beijing 100045)
Abstract：Objective To improve recognition of clinical securaty and success rate and choose correctly indication, way to foreign body removal from the trachea under general anesthesia.Methods Summarize 48 cases for foreign bodies of trachea to be removed under general anesthesia in 1984～1995 as the medical history, feature, position.Results It makes the 0.85% in the same period, the medical history from 2 day to one year. In these cases, over one month is 31, over 1 year is 4. Among 48 cases, chemical bodies are 14; plant bodies are 28; metallic bodies are 6; 3 cases are in the trachea , 20 cases are in the left bronchus; 25 cases are in the right bronchus. 45 cases have been removed; 3 cases have not been yet.Conclusion It is very secure, reliable to remove special complicated foreign body and it is important to choose correctly its indication, option under general anesthesia in the clinic.
Key words：General anesthesia Foreign bodies of trachea Indication▲
小儿气管异物很常见，我科门诊几乎天天碰到，绝大多数当日无麻醉取出，尤其是正气管异物需立即取出，如不及时抢救和取出可引起严重的并发症或死亡。
近年来，随着人民生活水平的提高，干果及文具用品种类的食用和使用增加，临床上气管异物的出现有增无减，异物的性质、形状、种类、所嵌入的部位、体内存留的时间及病人的年龄更加多样和复杂化，增加了在一般无麻醉取异物的难度，同时充分显示出了麻醉的必要性，使我们对麻醉的要求有了新的认识。临床观察和实践使我们对无麻醉和全麻进行了比较，对于难、险、重患儿的气管异物取出术，认为在全麻下施行能使患儿平静、舒适，减少危险性，更加安全，且使用合理，有利于病人康复。因此临床上使用日趋增多，但如何掌握全麻的适应证及方法，确保手术安全，争取一次成功，值得临床探讨。
临床资料
我科自1984～1995年共收治小儿气管异物58[1] [2] 下一页
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