摘要
本院2015年7月至2017年4月行双手粘连挛缩松解术的有严重并指畸形的遗传性大疱性表皮松解症患儿25例，男性10例，女性15例，年龄3～16岁，体重11～29 kg，ASA分级Ⅰ或Ⅱ级。入室前20 min时肌肉注射氯胺酮4～6 mg/kg和阿托品0.01 mg/kg。入室后面罩吸氧2 L/min。静脉注射咪达唑仑0.08 mg/kg和氯胺酮2 mg/kg诱导麻醉，保留患儿自主呼吸；静脉输注丙泊酚5 mg·kg－1·min－1和瑞芬太尼0.05～0.08 μg·kg－1·min－1维持麻醉。术中采用美皮贴保护皮肤，静脉输注钠钾镁钙葡萄糖注射液补充生理需要量、失血量及继续损失量。麻醉时间（130±43） min，手术时间（107±42） min，术中补液量（352±120） ml，出血量（29±10） ml，苏醒时间（15±6） min。术中发生呼吸抑制5例（20%）；术后新发大疱3例，其中背部1例，臀部2例。术中和术后均未见心血管事件发生。
Twenty-five pediatric patients （10 males, 15 females） with inherited epidermolysis bul- losa, aged 3-16 yr, weighing 11-29 kg, of American Society of Anesthesiologists physical status I or II , underwent lysis and reconstructive surgery of both hands adhesions from July 2015 to April 2017 in our hos- pital. Ketamine 4-6 mg/kg and atropine 0. 01 mg/kg were intramuscularly injected at 20 min before admis- sion to the operating room. Oxygen 2 L/rain was inhaled by mask after admission to the operating room. An- esthesia was induced by IV injection of midazolam 0.08 mg/kg and ketamine 2 mg/kg. Pediatric patients kept spontaneous breathing. Anesthesia was maintained by IV infusion of propofol 5 mg·kg-1·min-1 and remifentanil 0. 05-0.08 mg·kg-1·min-1. Mepitel was used to protect skin during surgery, and sodium potassium magnesium calcium and glucose injection was intravenously infused to replace the physiological re- quirement, blood loss and continued loss. Anesthesia time was （130±43） rain, surgery time （107±42） rain, the amount of intraoperative fluid infused （352±120） ml, blood loss （ 29± 10） ml and emergence time （15±6） rain. Intraoperative respiratory depression was found in 5 cases （20%）; postoperative new bullae occured in 3 cases, and among the 3 cases, one developed on the back and the other two on the but- tocks. No cardiovascular events occurred during and after surgery in this study.
出处
《中华麻醉学杂志》
CSCD
北大核心
2017年第9期1118-1120,共3页
Chinese Journal of Anesthesiology
关键词
表皮松解
大疱性
麻醉
Epidermolysis bullosa
Anesthesia
