泗水Soetomo综合学术医院全麻支气管镜检查患者气道异物

Annisa Maya Sabrina, Maulydia, R. F. Perdana, Mariza Fitriati
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引用次数: 1

摘要

简介:气道异物(AFBs)是ENT-HN(耳、鼻、喉-头颈)最常见的急症,需要立即治疗。房颤的金标准治疗是在全身麻醉下进行支气管镜检查。目的:本研究旨在确定2018年1月至2019年12月在泗水Soetomo总医院接受GA支气管镜检查的AFBs患者的概况。方法和材料:这是一项描述性、回顾性研究,使用的数据来自医疗记录。使用Microsoft Excel对数据进行分析。22例患者符合纳入标准。结果:11 ~ 20岁最常见(73%),其中女性占55%,男性占45%。患者分别来自泗水市外(73%)和城内(27%)。多达67%的样本患者咳嗽,23%的患者无症状。发现的异物包括大头针(67%)、剪贴板钉(14%)和螺母(9%)。这些房颤位于左主支气管(45%)、气管(32%)和右主支气管(18%),其中5%的病例无法定位房颤。从事件到支气管镜检查的持续时间大多小于1天(54%),2天(32%)和3天(14%)。大多数病例(90%)无AFBs并发症,但部分患者有梗阻(5%)和咯血(5%)。大多数患者也进行了无并发症的支气管镜检查(81%),然而,一些患者出现病变(14%)和出血(5%)。大多数患者也是ASA I(68%),其余分为ASA II(18%)和ASA III(14%)。用药前用药为芬太尼(41%)和芬太尼联合咪达唑仑(41%)。同时,最常维持的麻醉药物是异氟烷+O2(27%)。大多数患者也没有任何合并症(85%),但一些患者有贫血(5%),梗阻(5%),以及肥胖,随后有痰潴留和高钠血症(5%)。结论:GA下行支气管镜检查的AFB患者多为11-20岁,女性,临床症状以咳嗽为主。大多数afb位于左主支气管。从事件到支气管镜检查的时间少于1天。大多数患者也没有房颤和支气管镜检查的并发症。患者最常见的身体状态是ASA I,仅芬太尼或芬太尼和咪达唑仑作为用药前药物。维持麻醉最常用的药物是异氟醚和氧气的组合。大多数患者也没有GA的合并症因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Airway Foreign Bodies in Patients that Underwent Bronchoscopies with General Anesthesia in Dr. Soetomo General Academic Hospital Surabaya
Introduction: Airway foreign body (AFBs) is the most common emergency for ENT-HN (Ear, Nose, Throat-Head Neck) that requires immediate treatment. The gold standard management for AFBs is a bronchoscopy performed under general anesthesia (GA). Objective: This study aims to determine the profile of AFBs patients who underwent bronchoscopies with GA at Dr. Soetomo General Hospital Surabaya from January 2018 – December 2019. Methods and Materials: This is a descriptive, retrospective study that uses data from medical records. Microsoft Excel was used to analyze the data. 22 patients met the inclusion criteria. Results: The most common ages were 11 to 20-year-olds (73%), 55% were female, and 45% were male. The patients were from outside (73%) and inside (27%) Surabaya. As much as 67% of the sampled patients had coughs and 23% were symptomless. The foreign bodies found were pins (67%), clipboard nails (14%), and nuts (9%). These AFBs were located in the left main bronchus (45%), trachea (32%), and right main bronchus (18%), and in 5% of these cases, the AFBs could not be located. The duration between the event and the bronchoscopy was mostly less than 1 day (54%), 2 days (32%), and 3 days (14%). Most cases (90%) were without AFBs complications, but some had obstruction (5%), and hemoptysis (5%). Most patients also had an uncomplicated bronchoscopy (81%), however, some suffered lesions (14%) and bleeding (5%). A majority of the patients were also ASA I (68%), and the remainder were classified as ASA II (18%), and III (14%). The premedication drugs administered were fentanyl (41%), and a combination of fentanyl and midazolam (41%). Meanwhile, the most frequently maintained anesthetic agent was Isoflurane+O2 (27%). Most patients also did not have any comorbid factors (85%), but some had anemia (5%), obstruction (5%), as well as obesity followed by sputum retention and hypernatremia (5%). Conclusion: Most AFB patients who underwent bronchoscopy under GA were 11-20 years old, female, and had a cough as a clinical symptom. Most AFBs were pins at the left main bronchus. The duration between the incident and the bronchoscopy was less than 1 day. There were also mostly no complications of AFBs and bronchoscopies. The most common physical status in patients was ASA I, with fentanyl only or fentanyl and midazolam as a premedication drug. The most common agent used to maintain the anesthesia was a combination of isoflurane and O2. Most patients also had no comorbid factors for GA.
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