本文選題：小兒斜視矯正手術 + 七氟烷　； 參考：《醫(yī)學綜述》2016年16期

【摘要】：目的探討七氟烷復合丙泊酚用于小兒斜視矯正手術患兒的麻醉效果及其安全性。方法將2007年10月至2015年4月湖北省婦幼保健院收治的82例小兒斜視矯正手術患兒按照隨機數(shù)字表法分為觀察組和對照組,各41例。觀察組微量泵持續(xù)靜脈輸注3%~5%七氟烷復合6~10 mg/(kg·h)丙泊酚麻醉維持;對照組微量泵持續(xù)靜脈輸注氯胺酮2.5~8.0 mg/(kg·h)維持麻醉。對比分析兩組脈搏血氧飽和度(Sp O_2)、平均動脈壓(MAP)、心率、舒張壓、麻醉時間、手術時間、功醒時間、自主呼吸恢復時間、意識恢復時間、拔管時間及并發(fā)癥發(fā)生情況。結果觀察組心率T_2、T_3及T_4呈下降趨勢,對照組心率呈波動趨勢;兩組舒張壓呈T_2下降T_3及T_4升高的趨勢;觀察組MAP不同時間點的無明顯波動,對照組呈T_2、T_3升高T_4下降的趨勢,明顯波動。兩組心率、舒張壓、MAP的組間、不同時點間、組間·不同時點間的交互作用比較差異均有統(tǒng)計學意義(P0.05)。觀察組麻醉時間和蘇醒時間顯著短于對照組[(67±6)min比(91±7)min,(9.7±2.0)min比(15.3±2.7)min],差異有統(tǒng)計學意義(P0.05)。觀察組自主呼吸恢復時間顯著短于對照組[(1.6±0.4)min比(2.5±0.6)min],差異有統(tǒng)計學意義(P0.05)。觀察組惡心嘔吐、呼吸抑制、喚醒時痛感的發(fā)生率均顯著低于對照組[4.9%(2/41)比24.4%(10/41),2.4%(1/41)比29.3%(12/41),4.9%(2/41)比31.7%(13/41)],差異有統(tǒng)計學意義(P0.05)。結論七氟烷復合丙泊酚用于小兒斜視矯正手術患兒效果顯著,麻醉時間短,喚醒時間短,穩(wěn)定血流動力學狀態(tài),且并發(fā)癥少,臨床應用安全可靠,值得臨床上進一步推廣應用。
[Abstract]:Objective to investigate the anesthetic effect and safety of sevoflurane combined with propofol in pediatric strabismus correction.Methods from October 2007 to April 2015, 82 children undergoing strabismus correction were divided into observation group (n = 41) and control group (n = 41).The observation group received continuous intravenous infusion of 5% sevoflurane and 6 mg/(kg / h) propofol anesthesia, while the control group maintained the anesthesia by continuous intravenous infusion of ketamine 2.5 mg/(kg / h.The mean arterial pressure (MAPP), heart rate (HR), diastolic blood pressure (DBP), anesthesia time, operation time, wakeup time, spontaneous respiration recovery time, consciousness recovery time, extubation time and complications were compared between the two groups.Results the heart rate T _ 2C _ 3 and T _ 4 of the observation group showed a downward trend, while the heart rate of the control group showed a trend of fluctuation; the diastolic pressure of the two groups showed a tendency of decreasing T _ 3 and T _ 4; the MAP of the observation group had no obvious fluctuation at different time points, while the control group showed a tendency of increasing T _ (4) in T _ 2O _ T _ 3, and the diastolic blood pressure of the two groups showed a tendency of increasing T _ 3 and T _ 4.Obviously fluctuate.There were significant differences in the interaction between the two groups in heart rate, diastolic pressure and map, at different time points and at different time points (P 0.05).The anaesthesia time and recovery time in the observation group were significantly shorter than those in the control group [67 鹵6)min vs 91 鹵7 2.0)min vs 15.3 鹵2.7)min]. The difference was statistically significant (P 0.05).The recovery time of autonomic respiration in the observation group was significantly shorter than that in the control group [1.6 鹵0.4)min vs 2.5 鹵0.6)min], and the difference was statistically significant (P 0.05).Conclusion sevoflurane combined with propofol is effective in the correction of strabismus in children with short anesthesia time, short arousal time, stable hemodynamic state, less complications, safe and reliable clinical application, and worthy of further clinical application.
【作者單位】： 湖北省婦幼保健院眼科;
【分類號】：R726.1

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