七氟醚靜吸復合麻醉和瑞芬太尼復合丙泊酚麻醉用于小兒手術的臨床效果比較

官濤　羅云

【摘要】 目的：比較在小兒手術麻醉中七氟醚靜吸復合麻醉和瑞芬太尼復合丙泊酚麻醉的臨床效果。方法：選取2018年7月-2019年9月在筆者所在醫院中進行手術的患兒共90例，采用隨機分組法將患兒分成兩組，每組45例。對照組給予患兒瑞芬太尼復合丙泊酚麻醉，觀察組給予患兒七氟醚靜吸復合麻醉。觀察兩組患兒的不良反應發生率及麻醉效果。結果：觀察組不良反應發生率低于對照組，差異有統計學意義（P<0.05）。觀察組躁動評分、疼痛評分低于對照組，定向力恢復時間、蘇醒時間及拔管時間優于對照組，差異均有統計學意義（P<0.05）。結論：在小兒手術中，七氟醚靜吸復合麻醉效果明顯優于瑞芬太尼復合丙泊酚麻醉，有助于降低患兒不良反應發生率，是一種安全的麻醉方法，應在小兒手術麻醉中大力推廣使用。

【關鍵詞】 七氟醚靜吸復合麻醉 瑞芬太尼 丙泊酚 小兒手術

doi：10.14033/j.cnki.cfmr.2020.16.046 文獻標識碼 B 文章編號 1674-6805（2020）16-0-03

Comparison of the Clinical Effects of Sevoflurane Static Inhalation Combined Anesthesia and Remifentanil Combined with Propofol Anesthesia in Pediatric Surgery/GUAN Tao， LUO Yun. //Chinese and Foreign Medical Research， 2020， 18（16）： -116

[Abstract] Objective： The clinical therapeutic effects of Sevoflurane static inhalation combined anesthesia and Remifentanil combined with Propofol in pediatric anesthesia were compared. Method： A total of 90 cases of children undergoing surgery in the authors hospital from July 2018 to September 2019 were selected， and the children were randomly divided into two groups， with 45 cases in each group. The control group was anesthetized with Remifentanil combined Propofol， while the observation group was anesthetized with Sevoflurane static inhalation combined anesthesia. The incidence of adverse reactions and anesthetic effect of the two groups were observed. Result： The incidence of adverse reactions was lower in the observation group than that in the control group， the difference was statistically significant （P<0.05）. The scores of restlessness and pain in the observation were lower than those in the control group， the recovery time of orientation， recovery time and extubation time in the observation group were significantly better than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Sevoflurane static inhalation combined anesthesia is significantly better than Remifentanil combined with Propofol combined anesthesia in pediatric surgery， which is helpful to reduce the incidence of adverse reactions in children， and is a safe anesthesia method， which should be widely used in pediatric surgery anesthesia.

[Key words] Sevoflurane static inhalation combined anesthesia Remifentanil Propofol Pediatric surgery

First-authors address： Jingmen Maternal and Child Health Hospital， Jingmen 448000， China

當前，在小兒手術中主要是采用全身麻醉方法，在麻醉藥物選取上應以選擇安全性的麻醉藥物為主。相關的研究報道顯示，復合麻醉主要是運用藥物輔助作用，彌補單一麻醉藥物存在的不足，提升麻醉質量[1-2]?，F階段，小兒手術中常用的復合麻醉方法包括七氟醚靜吸復合麻醉和瑞芬太尼復合丙泊酚麻醉兩種方法，為了探究何種麻醉效果更為突出，本文選取2018年7月-2019年9月在筆者所在醫院中進行手術的90例患兒作為研究對象，比較在小兒手術麻醉中七氟醚靜吸復合麻醉和瑞芬太尼復合丙泊酚麻醉所取得的臨床效果，具體報道如下。

1 資料與方法

1.1 一般資料

選取2018年7月-2019年9月在筆者所在醫院中進行手術的患兒共90例，納入標準：（1）擇期手術;（2）無肝腎功能及心肺功能異常者;（3）手術時間<60 min。排除標準：（1）精神障礙者;（2）藥物禁忌證者;（3）合并呼吸系統疾病者。本次研究活動經醫院倫理委員會批準通過后進行，患兒家屬對本次研究活動知情，并簽署知情同意書。采用隨機分組法將患兒分成兩組。對照組45例，男23例，女22例;年齡為1～13歲，平均（6.5±2.8）歲;體重24～37 kg，平均（32.5±2.4）kg;手術類型：骨折手術10例，扁桃體手術22例，口腔手術8例，心臟手術3例，其他手術2例。觀察組45例，男21例，女

24例，年齡1～12歲，平均（6.8±2.5）歲;體重22～38 kg，平均（33.2±2.6）kg;手術類型：骨折手術9例，扁桃體手術20例，口腔手術10例，心臟手術4例，其他手術2例。……