資源描述:
《七氟烷全身麻醉在小兒腹腔鏡疝修補(bǔ)術(shù)中的應(yīng)用.pdf》由會員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫。
1、J實(shí)用臨床醫(yī)藥零志2013年第17卷第17期·36·ournalofCliniealMedicineinPractice?。????七氟烷全身麻醉在小兒腹腔鏡疝修補(bǔ)術(shù)中的應(yīng)用馬海燕,陳杰華(1.湖北省黃石市婦幼保健院麻醉科,湖北黃石,435000;2.湖北省黃石市中心醫(yī)院麻醉科,湖北黃石,435000)摘要:目的探討七氟烷全身麻醉在小兒腹腔鏡疝手術(shù)中的臨床應(yīng)用效果。方法選取6O例行腹腔鏡疝修補(bǔ)術(shù)的患兒作為研究對象,將其隨機(jī)分為觀察組和對照組,每組30例。觀察組患兒應(yīng)用七氟烷吸入誘導(dǎo)和維持麻醉,對照組患兒應(yīng)用丙泊酚靜脈誘導(dǎo)和維持麻醉,對2組患兒
2、手術(shù)各時間點(diǎn)的有創(chuàng)動脈壓(IBP)、心率(HR)、呼氣末二氧化碳分壓(PEtCZh)、血氧飽和度(SpO2)和氣道壓力峰值(Peak)的變化情況和清醒時間、清醒后躁動、術(shù)后24h惡心嘔吐(PONV)的情況進(jìn)行監(jiān)測和觀察。結(jié)果在手術(shù)過程中,2組患兒在形成氣腹后和形成氣腹10min后的IBP、HR和PEAK水平較手術(shù)前顯著升高(P<0.05);在形成氣腹10min后的PEtCO2水平較手術(shù)前顯著升高(P<0.05);在形成氣腹10rain后,對照組的PEAK水平顯著高于觀察組(P<0.05);觀察組患兒的清醒時間與對照組之間無顯著差異(P>0.0
3、5);觀察組患兒醒后出現(xiàn)躁動、清醒后24h出現(xiàn)PONV的比例顯著高于對照組(P<0.05)。結(jié)論在d,JL腹腔鏡疝修補(bǔ)術(shù)中應(yīng)用七氟烷全身麻醉的臨床效果較好,刺激較小,誘導(dǎo)和清醒均較快,但是術(shù)后出現(xiàn)躁動、惡心嘔吐的概率較高,應(yīng)及時做好預(yù)防。關(guān)鍵詞:七氟烷;小兒腹腔鏡疝修補(bǔ)術(shù);麻醉中圖分類號:R614文獻(xiàn)標(biāo)志碼:A文章編號:1672—2353(2013)17—036—03DOI:10.7619dcmp.201317011Applicationofsevofluraneanesthesiainpediatriclaparoscopicherni0r
4、rhaphyMAHaiyan,CHENJiehua(1.HuangshiWomenandChiMrenHealthCareHospital,Huangshi,Hubei,435000;2.HuangshiCentralHospital,Huangshi,Hubei,435000)ABSTRACT:ObjectivesToobserveandevaluatetheclinicaleffectsandadversereactionso{theapplicationofsevofluraneanesthesiainpediatriclaparosc
5、opicherniorrhaphy.MethodsSixtychildrentreatedwithlaparoscopicherniorrhaphywereselectedasthestudyobjectsandrandomlydi—videdintotheobservationgroupandthecontrolgroup.Thirtycaseswereincludedineachgroup.Thechildrenintheobservationgroupweretreatedwithsevofluraneinhalationforthei
6、nductionandmaintenanceofanesthesia,whilethechildreninthecontrolgroupweretreatedwithpropofolintra—venousdripfortheinductionandmaintenanceofanesthesia.Thechangesofinvasivearterialpres—sure(IBP),heartrate(HR),end—tidalcarbondioxidepartialpressure(PEtCOe),oxygensatura—tion(Sp02
7、),airwaypeakpressure(Peak)andthewake-uptime,agitationafterawaking,post—op—erativenauseaandvomiting(PONV)in24hafteroperationofthechildreninthetwogroupsatdif—ferenttimepointsweremonitoredandobserved.ResultsIntheoperationprocess,IBP,HRandPEAKlevelsofthepatientsinthetwogroupsat
8、thetimeofpneumoperitoneumformationand10minafterpneumoperitoneumformationincreaseds