發(fā)布時(shí)間：2018-06-27 11:18

  本文選題：小兒 + 腹腔鏡��； 參考：《中國醫(yī)藥指南》2016年01期

【摘要】：目的探討靜吸復(fù)合麻醉(七氟醚吸入復(fù)合丙泊酚+瑞芬太尼靜脈麻醉)用于小兒腹腔鏡疝修補(bǔ)術(shù)的麻醉效果。方法擇期小兒腹腔鏡疝高位結(jié)扎術(shù)60例,隨機(jī)分為七氟醚+丙泊酚+瑞芬太尼靜吸復(fù)合組(靜吸組,n=30);氯胺酮+丙泊酚+瑞芬太尼全憑靜脈組(靜脈組,n=30),觀察麻醉誘導(dǎo)入睡時(shí)間及手術(shù)過程中關(guān)鍵步驟時(shí)患兒心率(HR),平均動(dòng)脈壓(MAP)的變化,記錄自主呼吸恢復(fù)、拔除喉罩及出恢復(fù)室時(shí)間。結(jié)果靜吸組患兒誘導(dǎo)入睡快、術(shù)中平穩(wěn)、自主呼吸恢復(fù)、拔除喉罩及出恢復(fù)室時(shí)間較靜脈組明顯縮短(P0.05);靜脈組患兒誘導(dǎo)入睡時(shí)間長、置入喉罩、切皮、建立人工氣腹、拔除喉罩時(shí)的HR、MAP變化較靜吸組患兒變化顯著,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論七氟醚吸入復(fù)合丙泊酚+瑞芬太尼靜脈麻醉,誘導(dǎo)蘇醒快,術(shù)中血流動(dòng)力學(xué)穩(wěn)定,術(shù)后并發(fā)癥少,更適于小兒腹腔鏡疝高位結(jié)扎術(shù)。
[Abstract]:Objective to investigate the anesthetic effect of sevoflurane inhalation combined with propofol remifentanil for laparoscopic herniorrhaphy in children. Methods High ligation of laparoscopic hernia was performed in 60 children. They were randomly divided into sevoflurane propofol remifentanil compound group (intravenous group) and ketamine propofol remifentanil intravenous group (intravenous group). Changes in heart rate (HR), mean arterial pressure (map), The time of spontaneous respiration recovery, laryngeal mask extraction and recovery chamber was recorded. Results in the intravenous group, the time of inducing falling asleep was faster, the operation was stable, the spontaneous respiration was recovering, the time of removing larynx mask and recovering ventricle was shorter than that of the venous group (P0.05), the time of inducing to sleep was longer in the intravenous group, the laryngeal mask was placed, the skin was cut, the artificial pneumoperitoneum was established. The changes of HRP map in laryngeal mask group were significantly higher than those in static aspiration group (P0.05). Conclusion sevoflurane inhalation combined with propofol remifentanil intravenous anesthesia can induce fast recovery, stable hemodynamics and less postoperative complications. It is more suitable for high ligation of laparoscopic hernia in children.
【作者單位】： 江蘇省南通市如皋博愛醫(yī)院;
【分類號(hào)】：R726.1

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