七氟醚静吸复合麻醉和瑞芬太尼复合丙泊酚麻醉用于小儿手术的临床效果比较

官涛　罗云

【摘要】 目的：比较在小儿手术麻醉中七氟醚静吸复合麻醉和瑞芬太尼复合丙泊酚麻醉的临床效果。方法：选取2018年7月-2019年9月在筆者所在医院中进行手术的患儿共90例，采用随机分组法将患儿分成两组，每组45例。对照组给予患儿瑞芬太尼复合丙泊酚麻醉，观察组给予患儿七氟醚静吸复合麻醉。观察两组患儿的不良反应发生率及麻醉效果。结果：观察组不良反应发生率低于对照组，差异有统计学意义（P<0.05）。观察组躁动评分、疼痛评分低于对照组，定向力恢复时间、苏醒时间及拔管时间优于对照组，差异均有统计学意义（P<0.05）。结论：在小儿手术中，七氟醚静吸复合麻醉效果明显优于瑞芬太尼复合丙泊酚麻醉，有助于降低患儿不良反应发生率，是一种安全的麻醉方法，应在小儿手术麻醉中大力推广使用。

【关键词】 七氟醚静吸复合麻醉 瑞芬太尼 丙泊酚 小儿手术

doi：10.14033/j.cnki.cfmr.2020.16.046 文献标识码 B 文章编号 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

当前，在小儿手术中主要是采用全身麻醉方法，在麻醉药物选取上应以选择安全性的麻醉药物为主。相关的研究报道显示，复合麻醉主要是运用药物辅助作用，弥补单一麻醉药物存在的不足，提升麻醉质量[1-2]。现阶段，小儿手术中常用的复合麻醉方法包括七氟醚静吸复合麻醉和瑞芬太尼复合丙泊酚麻醉两种方法，为了探究何种麻醉效果更为突出，本文选取2018年7月-2019年9月在笔者所在医院中进行手术的90例患儿作为研究对象，比较在小儿手术麻醉中七氟醚静吸复合麻醉和瑞芬太尼复合丙泊酚麻醉所取得的临床效果，具体报道如下。

1 资料与方法

1.1 一般资料

选取2018年7月-2019年9月在笔者所在医院中进行手术的患儿共90例，纳入标准：（1）择期手术;（2）无肝肾功能及心肺功能异常者;（3）手术时间<60 min。排除标准：（1）精神障碍者;（2）药物禁忌证者;（3）合并呼吸系统疾病者。本次研究活动经医院伦理委员会批准通过后进行，患儿家属对本次研究活动知情，并签署知情同意书。采用随机分组法将患儿分成两组。对照组45例，男23例，女22例;年龄为1～13岁，平均（6.5±2.8）岁;体重24～37 kg，平均（32.5±2.4）kg;手术类型：骨折手术10例，扁桃体手术22例，口腔手术8例，心脏手术3例，其他手术2例。观察组45例，男21例，女

24例，年龄1～12岁，平均（6.8±2.5）岁;体重22～38 kg，平均（33.2±2.6）kg;手术类型：骨折手术9例，扁桃体手术20例，口腔手术10例，心脏手术4例，其他手术2例。……