作　　者： (曾宪明）; (李王明）; (张海龙）; (周笑）; (田树勇）; (李珊珊）; (胡艳杰）; (章颖）; (祁桂明）;

机构地区： 江苏省沭阳县中医院麻醉科,223600

出　　处： 《中华麻醉学杂志》 2017年第7期792-795,共4页

摘　　要： 目的 评价患儿扁桃体切除术中体位和气管导管位置对套囊压力的影响.方法 全身麻醉下扁桃体切除术患儿60例,年龄3-12岁,采用随机数字表法分为2组（n=30）：A组将气管导管放置于Davis开口器压舌板一侧;B组将气管导管放在压舌板与舌体之间.于头中立位（T1）、改为头后仰位（T2）、手术位（T3）时记录套囊压力.结果 与T1时比较,T2时2组套囊压力升高（P〈0.0l）;与T2时比较,T3时A组套囊压力升高,B组套囊压力降低（P〈0.01）.与A组比较,B组T3时套囊压力降低（P〈0.01）,T1,2时差异无统计学意义（P〉0.05）.结论 患儿扁桃体切除术中套囊压力受体位和气管导管位置的影响,建议常规监测套囊压力. Objective To evaluate the effects of body position and cuffed endotracheal tube （cETT） position on the intracuff pressure during tonsillectomy in the pediatric patients.Methods Sixty pediatric patients,aged 3-12 yr,scheduled for elective tonsillectomy under general anesthesia,were divided into group A and group B using a random number table,with 30 patients in each group.The cETTs were placed on one side of the blade of Davis retractor in group A.The cETTs were placed between the blade of Davis retractor and the body of tongue in group B.The intracuff pressure was recorded when the head was in the neutral position （T1）,after changing to the head back position （T2） and when the retractor was placed for operation （T3）.Results The intracuff pressure was significantly higher at T2 than at T1 in the two groups （P〈0.01）.The intracuff pressure was significantly higher at T3 in group A and lower at T3 in group B than at T2 （P〈0.01）.Compared with group A,the intracuff pressure was significantly decreased at T3 （P〈0.01）,and no significant change was found in the intracuff pressure at T1,2 in group B （P〉0.05）.Conclusion The intracuff pressure is affected by body position and cETT position during tonsillectomy in the pediatric patients,and routine monitoring of the intracuff pressure is recommended.

关 键 词： 儿童 扁桃体切除术 插管法 气管内 体位 压力