CAJ | 학술논문

　　目的探讨七氟醚复合瑞芬太尼丙泊酚全麻在小儿耳鼻喉手术中的应用。方法回顾性分析68例患儿全麻下进行小儿耳鼻喉手术，根据麻醉方法分为丙泊酚复合瑞芬太尼组（A组）和七氟醚复合瑞芬太尼丙泊酚组（B组），每组患儿34例。麻醉诱导后，A组麻醉方法，通过持续输入丙泊酚和瑞芬太尼维持麻醉；B组麻醉方法，在A组的基础上同时持续吸入七氟醚。以手术麻醉前T0时刻的血流动力学和心肺功能指标为基础值，两组患者对比麻醉前后和麻醉恢复各个时期的各指标变化。结果A组血流动力学HR、SBP、SBP等指标比B组波动幅度大。B组的麻醉效果比A组稳定。麻醉术后恢复情况，A组对应时间显著短于B组（P＜0.05），躁动方面B组少于A组。结论七氟醚复合瑞芬太尼丙泊酚全麻在小儿耳鼻喉手术中血流动力学更稳定，麻醉效果良好，发生躁动概率较低。
　　목적탐토칠불미복합서분태니병박분전마재소인이비후수술중적응용。방법회고성분석68례환인전마하진행소인이비후수술，근거마취방법분위병박분복합서분태니조（A조）화칠불미복합서분태니병박분조（B조），매조환인34례。마취유도후，A조마취방법，통과지속수입병박분화서분태니유지마취；B조마취방법，재A조적기출상동시지속흡입칠불미。이수술마취전T0시각적혈류동역학화심폐공능지표위기출치，량조환자대비마취전후화마취회복각개시기적각지표변화。결과A조혈류동역학HR、SBP、SBP등지표비B조파동폭도대。B조적마취효과비A조은정。마취술후회복정황，A조대응시간현저단우B조（P＜0.05），조동방면B조소우A조。결론칠불미복합서분태니병박분전마재소인이비후수술중혈류동역학경은정，마취효과량호，발생조동개솔교저。
Objective To investigate the application of sevoflurane combined with remifentanil and propofol in pediatric ENT operation. Methods 68 patients with pediatric otorhinolaryngology operation under general anesthesia, were randomly divided into propofol and remifentanil group(group A), and sevoflurane combined with remifentanil and propofol group(group B), with 34 cases each. After induction of anesthesia, group A was maintained anesthesia through the continuous input of propofol and remifentanil; group B was taking the continuous inhalation of sevoflurane at the same time, on the basis of group A. The changes of the index at each period of anesthesia were compared before and after anesthesia between the two groups, based on the value of hemodynamics and heart and lung function index at T0 time before anesthesia. Results HR, SBP, SBP and hemodynamic index in group A had a higher fluctuation than those in group B. The anesthesia effect was more stable than that in group B. The recovery corresponding time in group A was significantly shorter than that in group B after anesthesia (P<0.05), and the agitation in group B was less than that in group A. Conclusion Sevoflurane combined with remifentanil and propofol in pediatric otolaryngology, the blood flow dynamics had a more stable operation,better anesthetic effect, lower probability of emergence agitation.