CAJ | 학술논문

目的观察盐酸戊乙奎醚-氯胺酮-丙泊酚静脉麻醉复合局部浸润麻醉方法用于先天性心脏病(CHD)经导管封堵术中的效果.方法选择86例先天性心脏病应用Amplatzer型封堵器经导管封堵术的患儿,随机分为两组:氯胺酮-丙泊酚静脉麻醉复合局部浸润麻醉组(A组)及盐酸戊乙奎醚-氯胺酮-丙泊酚静脉麻醉复合局部浸润麻醉组(B组),每组各43例.结果 A组6例(14.0%)患儿术中出现口腔分泌物增多,一度出现轻度上呼吸道梗阻,经吸痰加给氧后缓解;16例(37.2%)患儿在心导管探插或心内操作时出现心律失常;手术时间为(2.65±1.85)h;术毕麻醉苏醒时间为(4S.4±15.2)min.B组2例(4.7%)患儿术中出现上呼吸道梗阻,经减轻麻醉后梗阻缓解,与A组比较差异有统计学意义(P<0.05);15例(34.9%)患儿在心导管探插或心内操作时出现心律失常;手术时间为(2.58±1.74)h;术毕麻醉苏醒时间为(50.2±17.3)min,后三者与A组比较差异均无统计学意义.结论盐酸戊乙奎醚-氯胺酮-丙泊酚静脉麻醉复合局部浸润麻醉可安全有效地应用于先天性心脏病经导管封堵术中.
목적 관찰염산무을규미-록알동-병박분정맥마취복합국부침윤마취방법용우선천성심장병(CHD)경도관봉도술중적효과.방법 선택86례선천성심장병응용Amplatzer형봉도기경도관봉도술적환인,수궤분위량조:록알동-병박분정맥마취복합국부침윤마취조(A조)급염산무을규미-록알동-병박분정맥마취복합국부침윤마취조(B조),매조각43례.결과 A조6례(14.0%)환인술중출현구강분비물증다,일도출현경도상호흡도경조,경흡담가급양후완해;16례(37.2%)환인재심도관탐삽혹심내조작시출현심률실상;수술시간위(2.65±1.85)h;술필마취소성시간위(4S.4±15.2)min.B조2례(4.7%)환인술중출현상호흡도경조,경감경마취후경조완해,여A조비교차이유통계학의의(P<0.05);15례(34.9%)환인재심도관탐삽혹심내조작시출현심률실상;수술시간위(2.58±1.74)h;술필마취소성시간위(50.2±17.3)min,후삼자여A조비교차이균무통계학의의.결론 염산무을규미-록알동-병박분정맥마취복합국부침윤마취가안전유효지응용우선천성심장병경도관봉도술중.
Objective To observe the effects of combined penebyclidine hydrochloride-ketamine-propofoi intravenous anesthesia with local anesthesia in transcatheter occlusion of congenital heart diseases (CHD).Methods Eighty-six patients suffered in CHD scheduled for transcatheter Amplatzer occlusio were divided randomly and averagely into two groups with 43 cases each.Group A received combined ketamine--propofol ina'avenous anesthesia with local anesthesia. Group B received combined hydrochloride-ketamine-propofol intavenous anesthesia with local anesthesia.Results The rate of upper airway obstruction of child patient that was caused by increased oral secretion in group B (4.7%) was significantly lower than that in group A(14.0%) (P ＜ 0.05 ).The upper airway obsa-uction was removed by aspirating sputum and oxygen therapy in group A,while removed "by decreasing anesthetic depth in group B.The rate of arrhythmia in operation,the time of operation and wake-up time were not significantly different between two groups [37.2%,(2.65±1.85)h,(45.4±15.2)min in group A,but 34.9%,(2.58±1.74)h,(50.2±17.3)rain in group B (P＞0.05)].Conclusion The combined penehyclidine hydrochloride-ketamine-propofol intravenous anesthesia with local anesthesia is feasible and safe in transcatheter occlusion of congenital heart diseases.