摘要
目的比较七氟烷与异丙酚在儿童腹股沟疝手术中的麻醉效果及对患儿血气等的影响。方法选取2016年1月至2018年5月,东台市人民医院就诊的52例腹股沟疝患儿,随机分为SR组(26例)和PR组(26例)。所有患儿均接受择期手术治疗,SR组患儿给予七氟烷及瑞芬太尼进行术中麻醉维持;PR组患儿给予异丙酚及瑞芬太尼进行术中麻醉维持。观察并比较2组患儿的呼吸恢复时间、清醒时间、血气分析指标、血流动力学指标以及麻醉并发症发生情况。结果2组患儿的呼吸恢复时间和清醒时间比较,差异无统计学意义(P>0.05)。麻醉后10min与术前比较,2组患儿血氧分压(partial pressure of oxygen,PaO2)、收缩压(systolic blood pressure,SBP)、舒张压(systolic blood pressure,DBP)、心率(heart rate,HR)水平降低,二氧化碳分压(partial pressure of carbon dioxide,PCO2)水平升高(P<0.05),但血氧饱和度(pulse oxygen saturation,SpO2)水平改变差异无统计学意义(P>0.05)。切皮时与术前相比,2组患儿PaO2、SBP、DBP、HR水平均降低,PaCO2水平升高(P<0.05),但SaO2水平改变差异无统计学意义(P>0.05)。切皮时,PR组的SBP、DBP水平高于SR组(P<0.05),HR水平改变差异无统计学意义(P>0.05)。SR组的术后躁动发生率(38.46%)高于PR组(11.54%)(P<0.05);2组均无恶性呕吐发生,2组的剧烈呛咳发生率差异无统计学意义(P>0.05)。结论七氟烷与异丙酚在儿童腹股沟疝手术中的麻醉过程中均会对患儿的呼吸功能以及血流动力学产生一定的影响,七氟烷麻醉对患儿的血流动力学指标的影响小于异丙酚,但七氟烷麻醉术后躁动发生率较高,二者均为适用于小儿麻醉的有效药物。
Objective To compare the anesthetic effect and blood gas influence between sevoflurane(S)and propofol(P)in the operation of inguinal hernia in children.Methods 52 cases of inguinal hernia in general surgery of Dongtai People’s hospital from January 2016 to May 2018 were randomly divided into the SR group(26 cases)and the PR group(26 cases).All patients received selective surgery,sevoflurane and remifentanil(R)were used for maintenance of anesthesia in the SR group,while propofol and remifentanil were used for maintenance of anesthesia in the PR group.Respiratory recover y time,awakening time,blood gas analysis index,hemodynamic index and incidence of anesthesia complications were compared between the two groups.Results There was no significant difference in the recovery time of breathing and awakening time between the two groups(P>0.05).At 10 minutes after anesthesia,the levels of PaO2,SBP,DBP and HR decreased,while the level of PCO2 increased(P<0.05),but there was no significant difference in the changes of SaO2 in the two groups(P>0.05).Compared with preoperative,the levels of PaO2,SBP,DBP and HR decreased at skin incision cutting and,while the level of PaCO2 increased in the two groups(P<0.05),but there was no significant difference in the changes of SaO2(P>0.05).The levels of SBP and DBP in the PR group were higher than those in the SR group(P<0.05),but there was no significant difference in the level of HR(P>0.05).The incidence of restlessness in the SR group(38.46%)was higher than that in the PR group(11.54%)(P<0.05);there was no malignant vomiting in both groups,and there was no significant difference in the incidence of severe cough between the two groups(P>0.05).Conclusion SR and PR have certain effects on respiratory function and hemodynamics in children undergoing inguinal hernia surgery.R anesthesia has less effect on hemodynamic parameters such as SBP and DBP in children than P,but the incidence of restlessness after R anesthesia is higher.Both of them are effective drugs for pediatric anesthesia.T
作者
姜曜
Jiang Yao(Department of Pharmacy,Dongtai People's Hospital,Jiangsu 224299,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2019年第3期238-242,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
腹股沟
儿童
血流动力学
并发症
Hernia,inguinal
Child
Blood gas
Hemodynamics
Complications
