带套囊气管导管在小儿全身麻醉扁桃体射频消融术中的应用*

Clinical application of cuffed endotracheal tube in pediatric patients undergoing tonsil radiofrequency ablation surgery*

摘要:

目的 研究小儿扁桃体射频消融术全身麻醉气管插管时带套囊气管导管应用的安全性。方法 选取2017年11月—2018年1月天津市儿童医院全身麻醉下行扁桃体射频消融术患儿100例。根据气管导管有无套囊选择情况，随机分为带套囊气管导管组（T组）和不带套囊气管导管组（N组），主要观察指标为拔管后有无喘鸣，次要观察指标为控制呼吸时有无漏气、插管后是否换管、拔管后SpO2最低值以及术后插管相关并发症。结果 两组患儿性别构成、年龄、体重和插管管号等一般情况比较差异无统计学意义（P?>0.05）。两组患儿术中情况比较发现，两组患儿机械通气时间比较，差异无统计学意义（P?>0.05）；T组患儿中有1例术中出现漏气，有1例更换气管导管，N组患儿中有11例出现术中漏气，有8例更换气管导管，两组比较差异有统计学意义（P?<0.05）；两组患儿术毕拔管时喘鸣和拔管后SpO2最低值比较差异无统计学意义（P?>0.05），但T组患儿拔管时未吸出气管内血性分泌物，N组患儿拔管时有6例出现气管内血性分泌物，两组比较差异有统计学意义（P?<0.05）。结论 带套囊气管导管可安全用于8岁以下小儿行全身麻醉下扁桃体射频消融术，且不增加小儿拔管术后喘鸣发生率。

Abstract:

Objective To evaluate the clinical application of cuffed endotracheal tube in pediatric patients undergoing tonsil radiofrequency ablation surgery. Methods Totally 100 children aging from 3 years old to 8 years old received tonsil radiofrequency ablation in Tianjin Children’s Hospital from December 2017 to January 2018. Clinical performance of cuffed and uncuffed endotracheal tube were recorded. The primary endpoint was the stridor after extubation, and the secondary endpoints included leakage during controlled respiration, tube exchange after intubation, lowest value of SpO2 after extubation, and complications related to intubation. Results No significant difference in gender, age, weight, size of endotracheal tube, and time of duration of intubation were observed between two groups. There was 1 patient with air leakage and 1 patient needed to switch tube size in cuffed group. There were 11 patients with air leakage and 8 patients needed to switch tube size in uncuffed group (P? 0.05). Six patients in uncuffed group had bloody secretion after extubation while no complications occurred in cuffed group (P?