中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
18期
11-14
,共4页
斜视%七氟烷%可弯曲喉罩
斜視%七氟烷%可彎麯喉罩
사시%칠불완%가만곡후조
Strabismus%Sevoflurane%Flexible laryngeal mask airway
目的 评价可弯曲喉罩通气下七氟烷麻醉用于小儿斜视矫治术的效果.方法 择期行斜视矫治术患儿60例,按随机数字表法分为气管导管组和可弯曲喉罩组,每组30例.气管导管组静吸复合麻醉,气管插管,机械通气;可弯曲喉罩组七氟烷麻醉,置入可弯曲喉罩,保留自主呼吸.记录多时点气道峰压和平均气道压.记录气管导管或喉罩置人即刻(T1)、1 min(T2)、3 min(T3)、5 min(T4)和拔出气管导管或喉罩即刻(T5)时血压、心率.记录苏醒时间和拔管时间;患儿从苏醒到拔出气管导管或喉罩时呛咳、躁动和术后咽痛的情况及家长的满意度.结果 与基础值比较,气管导管组T1时收缩压下降,T2、T3、T5时收缩压升高,T2～T5时心率升高,可弯曲喉罩组T1～T4时收缩压、舒张压下降(P<0.05);与气管导管组比较,可弯曲喉罩组T2～T5时收缩压、舒张压、心率均降低(P<0.05).气管导管组苏醒时间(8.1±2.6)min,拔管时间(12.6±3.2)min,从苏醒到拔出气管导管或喉罩时呛咳发生率66.7%(20/30)、咽痛发生率40.0%(12/30)、躁动评分0～1分7例,可弯曲喉罩组分别为(5.2±1.1)min、(6.3±1.5)min、0、6.7%(2/30)、25例,两组比较差异有统计学意义(P<0.05).与气管导管组比较,可弯曲喉罩组患儿家长的满意度高,差异有统计学意义(P<0.05).结论 可弯曲喉罩通气下七氟烷麻醉更适合于小儿斜视矫治术.
目的 評價可彎麯喉罩通氣下七氟烷痳醉用于小兒斜視矯治術的效果.方法 擇期行斜視矯治術患兒60例,按隨機數字錶法分為氣管導管組和可彎麯喉罩組,每組30例.氣管導管組靜吸複閤痳醉,氣管插管,機械通氣;可彎麯喉罩組七氟烷痳醉,置入可彎麯喉罩,保留自主呼吸.記錄多時點氣道峰壓和平均氣道壓.記錄氣管導管或喉罩置人即刻(T1)、1 min(T2)、3 min(T3)、5 min(T4)和拔齣氣管導管或喉罩即刻(T5)時血壓、心率.記錄囌醒時間和拔管時間;患兒從囌醒到拔齣氣管導管或喉罩時嗆咳、躁動和術後嚥痛的情況及傢長的滿意度.結果 與基礎值比較,氣管導管組T1時收縮壓下降,T2、T3、T5時收縮壓升高,T2～T5時心率升高,可彎麯喉罩組T1～T4時收縮壓、舒張壓下降(P<0.05);與氣管導管組比較,可彎麯喉罩組T2～T5時收縮壓、舒張壓、心率均降低(P<0.05).氣管導管組囌醒時間(8.1±2.6)min,拔管時間(12.6±3.2)min,從囌醒到拔齣氣管導管或喉罩時嗆咳髮生率66.7%(20/30)、嚥痛髮生率40.0%(12/30)、躁動評分0～1分7例,可彎麯喉罩組分彆為(5.2±1.1)min、(6.3±1.5)min、0、6.7%(2/30)、25例,兩組比較差異有統計學意義(P<0.05).與氣管導管組比較,可彎麯喉罩組患兒傢長的滿意度高,差異有統計學意義(P<0.05).結論 可彎麯喉罩通氣下七氟烷痳醉更適閤于小兒斜視矯治術.
목적 평개가만곡후조통기하칠불완마취용우소인사시교치술적효과.방법 택기행사시교치술환인60례,안수궤수자표법분위기관도관조화가만곡후조조,매조30례.기관도관조정흡복합마취,기관삽관,궤계통기;가만곡후조조칠불완마취,치입가만곡후조,보류자주호흡.기록다시점기도봉압화평균기도압.기록기관도관혹후조치인즉각(T1)、1 min(T2)、3 min(T3)、5 min(T4)화발출기관도관혹후조즉각(T5)시혈압、심솔.기록소성시간화발관시간;환인종소성도발출기관도관혹후조시창해、조동화술후인통적정황급가장적만의도.결과 여기출치비교,기관도관조T1시수축압하강,T2、T3、T5시수축압승고,T2～T5시심솔승고,가만곡후조조T1～T4시수축압、서장압하강(P<0.05);여기관도관조비교,가만곡후조조T2～T5시수축압、서장압、심솔균강저(P<0.05).기관도관조소성시간(8.1±2.6)min,발관시간(12.6±3.2)min,종소성도발출기관도관혹후조시창해발생솔66.7%(20/30)、인통발생솔40.0%(12/30)、조동평분0～1분7례,가만곡후조조분별위(5.2±1.1)min、(6.3±1.5)min、0、6.7%(2/30)、25례,량조비교차이유통계학의의(P<0.05).여기관도관조비교,가만곡후조조환인가장적만의도고,차이유통계학의의(P<0.05).결론 가만곡후조통기하칠불완마취경괄합우소인사시교치술.
Objective To evaluate the efficacy of flexible laryngeal mask airway and sevoflurane in pediatric strabismus surgery. Methods Totally 60 children undergoing elective strabismus surgery were recruited and divided into two groups with 30 cases each by random digits table:group T, in which children accepted endotracheal tube intubation and combined intravenous and inhalation anesthesia with mechanically ventilation; and group F, in which children adopted both flexible laryngeal mask airway and inhalation anesthesia of sevoflurane with spontaneous breath. Airway peak pressure (Ppeak), average airway pressure (Pmean), blood pressure (Bp) and heart rate (HR) at induction (T1), 1 min (T2), 3 min (T3) and 5 min (T4) after induction, removal of endotracheal tube or laryngeal mask airway (T5), awaking time and extubation time, occurrence of cough, dysphoria and pharyngodynia from being awake to extubation, satisfaction of patients were recorded. Results When compared to baseline, systolic pressure was lower at T, and higher at T2, T3 and T5, and HR was higher at T2-T5 in group T(P< 0.05),Bp was lower at T1-T4 in group F (P < 0.05). Bp and HR at T2-T5 in group F were lower than those in group T (P < 0.05). The awaking time was (8.1 ?2.6) min, the extubation time was (12.6 ?3.2) min, the occurrence of cough and pharyngodynia was 66.7%(20/30), 40.0%( 12/30), the dysphoria (0-1 score) was 7 cases in group T,(5.2 ± 1.1) min, (6.3 ± 1.5) rain,0,6.7%(2/30),25 cases in group F. There were significant differences between two groups (P<0.05). The satisfaction of patients in group F was higher than that in group T, there was significant difference between two groups (P< 0.05). Conclusion Flexible laryngeal mask airway with sevoflurane could offer high efficacy in pediatric strabismus surgery.
