全身麻醉下内镜视频监视系统辅助支气管镜诊治小儿气管支气管异物

摘要

[Objective] The cases of bronchial foreign body of children in last two years were retrospectively analyzed, which were all treated under general anesthesia with bronchial endoscope and video monitor in otolaryngology department of the first affiliated hospital of Sun Yat-Sen University. [ Methods ] The foreign bodies were all took out by special forcep under bronchial endoscope and monitor, and the bronchial endoscope with 2.7mm diameter and 40cm length was put into the hole of the special forcep to make a clear view* on the monitor. Then the forcep with inserted bronchial endoscope was put into bronchoscope, which was directly put into bronchial tract at a right direction. [Results] All 46 cases were all well treated with the foreign bodies took out. The operation time was 5 minutes to 40 minutes. No complications such as pneumothorax, laryngospasm and apnea happened.[ Conclusions J Assembly of bronchial endoscope, special forcep and bronchoscope with video monitor could make a clear view and make it easy to take out the bronchial foreign bodies under general anesthesia with controlled respiration when muscle relaxants are used. The efficacy is satisfactory and the complication is less.%目的 回顾分析中山大学附属第一医院耳鼻咽喉科近3年来全身麻醉下内镜视频监视系统辅助支气管镜诊治小儿气管支气管异物病例.方法 患儿均接受气管插管全身麻醉,利用肌松剂阻断患儿呼吸,呼吸机辅助通气,将直径2.7mm,长40 cm支气管内镜套入专用的异物钳中,再将其内已套入内镜的异物钳自支气管镜内置入,即可在视频监视系统下利用异物钳调整好钳取位置顺利取出异物.结果 所有46例病例均利用此方法顺利取出异物,手术所需时间5～40min.所有病例均未发生气胸、喉痉挛、窒息等并发痘.结论 在全身麻醉肌松剂阻断呼吸辅助通气的麻醉条件下,利用支气管内镜、专用的异物钳、支气管镜组合一起,于内镜视频监视系统辅助下,可以获得比较清晰的视野,可以很准确方便地取出异物,防止并发症的发生,取得满意的疗效.