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目的:探讨采用气管内镜及微切割钻治疗气管内乳头状瘤患儿在全身麻醉过程中间断拔出气管插管进行手术操作时,患儿对通气暂停的耐受情况。方法:选取40例有气管内累及的呼吸道乳头状瘤患儿,在全身麻醉手术过程中间断拔出气管插管进行手术操作,观察脉搏血氧饱和度(SpO2)由100%下降到99%,95%,90%,85%时所用的时间及当时的心率、SpO2降至85%时的血氧分压(PaO2)、二氧化碳分压(PaCO2)、pH。SpO2重新回升至100%时所用的时间以及PaO2、PaCO2、pH。结果:拔出气管插管后SpO2由100%下降到99%,95%,90%,85%时的平均时间(s)依次为168.4±58.3,204.6±56.4,224.8±58.9,239.9±60.6;平均心率(次/min)依次为121.6±14.6、123.3±15.1、124.1±14.8、125.0±15.1;SpO2为85%时的PaO2为(52±7.9)mmHg,PaCO2为(69±8.7)mmHg,pH为7.22±0.05;SpO2回升至100%所需时间为(28.6±2.5)s,PaO2为(358±104.3)mm-Hg,PaCO2为(40.5±2.0)mmHg,pH为7.40±0.02。结论:呼吸道乳头状瘤患儿在手术时通过间歇通气给氧是安全可靠的,单次通气暂停时间控制在3~5 min时,患儿出现的低氧和高碳酸血症可被及时纠正。
Objective: To investigate the endotracheal tolerance of children with endotracheal intubation during tracheal intubation with tracheal endotracheal intubation and microdissection drilling for the treatment of children with endotracheal papilloma during general anesthesia. Methods: Totally 40 children with respiratory papilloma were included in the study. During the operation of general anesthesia, the tracheal intubation was interrupted and operation was performed. The SpO2 was decreased from 100% to 99% 95%, 90%, 85% of the time spent and the current heart rate, SpO2 dropped to 85% of the partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), pH. The time taken for SpO2 to rise back to 100% and PaO2, PaCO2, pH. Results: The mean time (s) of SpO2 decreased from 100% to 99%, 95%, 90% and 85% after removing the tracheal intubation was 168.4 ± 58.3, 204.6 ± 56.4, 224.8 ± 58.9 and 239.9 ± 60.6, respectively. The average heart rate was 121.6 ± 14.6, 123.3 ± 15.1, 124.1 ± 14.8 and 125.0 ± 15.1 in turn; PaO2 was (52 ± 7.9) mmHg at PaO2 85% and (69 ± 8.7) mmHg at PaCO2 Was 7.22 ± 0.05; the time required for SpO2 to recover to 100% was (28.6 ± 2.5) s, PaO2 was (358 ± 104.3) mm-Hg, PaCO2 was (40.5 ± 2.0) mmHg and pH was 7.40 ± 0.02. Conclusion: It is safe and reliable for children with respiratory papilloma to be ventilated intermittently during operation. The hypoxemia and hypercapnia in children can be corrected in 3 ~ 5 min after the single pause time is controlled.