环球中医药
環毬中醫藥
배구중의약
GLOBAL TCM
2013年
z1期
6-6,7
,共2页
骶麻%喉罩麻醉%小儿%下腹部手术
骶痳%喉罩痳醉%小兒%下腹部手術
저마%후조마취%소인%하복부수술
The sacral linen%Laryngeal mask anesthesia%Children%Lower abdominal surgery
目的：通过对喉罩置入下行全麻及基础麻醉下行骶管阻滞两种麻醉方式应用于小儿下腹部手术的麻醉效果比较及并发症的比较。方法本次共选择100例小儿下腹部手术患儿作研究对象，均为我院2011年5月至2013年5月收治，随机分组为芬太尼、丙泊酚基础麻醉下行骶麻（骶麻组）与喉罩全麻（喉罩组）。结果与 T0时比较，T1、T 2、T3时二组 MAP 均明显降低，HR 有所减慢（P＜0.05）；与喉罩组比较，T4时骶麻组 MAP及 HR明显较低（P＜0.05）；骶麻组呼吸抑制发生率较高（P＜0.05），术后躁动、恶心呕吐发生较少（P均＜0.05）；相较喉罩组，骶麻组苏醒时间较早，麻醉费用少于对照组（P均＜0.05）；喉罩组置入成功率接近100％，而骶麻组有接近8％的麻醉失败或效果不完善，需改氯胺酮静脉麻醉或全麻。结论两种麻醉方式用于小儿下腹部手术，有各自优缺点，麻醉医师应根据自身擅长、小儿情况、手术范围及时间长短，灵活应用两种麻醉方式。
目的：通過對喉罩置入下行全痳及基礎痳醉下行骶管阻滯兩種痳醉方式應用于小兒下腹部手術的痳醉效果比較及併髮癥的比較。方法本次共選擇100例小兒下腹部手術患兒作研究對象，均為我院2011年5月至2013年5月收治，隨機分組為芬太尼、丙泊酚基礎痳醉下行骶痳（骶痳組）與喉罩全痳（喉罩組）。結果與 T0時比較，T1、T 2、T3時二組 MAP 均明顯降低，HR 有所減慢（P＜0.05）；與喉罩組比較，T4時骶痳組 MAP及 HR明顯較低（P＜0.05）；骶痳組呼吸抑製髮生率較高（P＜0.05），術後躁動、噁心嘔吐髮生較少（P均＜0.05）；相較喉罩組，骶痳組囌醒時間較早，痳醉費用少于對照組（P均＜0.05）；喉罩組置入成功率接近100％，而骶痳組有接近8％的痳醉失敗或效果不完善，需改氯胺酮靜脈痳醉或全痳。結論兩種痳醉方式用于小兒下腹部手術，有各自優缺點，痳醉醫師應根據自身擅長、小兒情況、手術範圍及時間長短，靈活應用兩種痳醉方式。
목적：통과대후조치입하행전마급기출마취하행저관조체량충마취방식응용우소인하복부수술적마취효과비교급병발증적비교。방법본차공선택100례소인하복부수술환인작연구대상，균위아원2011년5월지2013년5월수치，수궤분조위분태니、병박분기출마취하행저마（저마조）여후조전마（후조조）。결과여 T0시비교，T1、T 2、T3시이조 MAP 균명현강저，HR 유소감만（P＜0.05）；여후조조비교，T4시저마조 MAP급 HR명현교저（P＜0.05）；저마조호흡억제발생솔교고（P＜0.05），술후조동、악심구토발생교소（P균＜0.05）；상교후조조，저마조소성시간교조，마취비용소우대조조（P균＜0.05）；후조조치입성공솔접근100％，이저마조유접근8％적마취실패혹효과불완선，수개록알동정맥마취혹전마。결론량충마취방식용우소인하복부수술，유각자우결점，마취의사응근거자신천장、소인정황、수술범위급시간장단，령활응용량충마취방식。
Objective through to the laryngeal mask into downward general and basic anesthesia downlink sacral canal blocking with-out using the two anesthesia effect comparison and complication of abdominal surgery under anesthesia .Methods the selected 100 cases of children with children's lower abdominal surgery as the research object ,are from May 2011 to May 2011 treated ,randomly assigned as the foundation of fentanyl ,propofol anesthesia downlink sacral hemp sacral (ma) and laryngeal mask anesthesia group (laryngeal mask) .Re-sults compared with the T0 ,T1 ,t2 ,T3 ,MAP the second group were significantly lower ,HR has slowed (P<0.05);When compared with laryngeal mask set ,T4 sacral MAP and HR hemp group was obviously lower (P<0.05);Sacral hemp groups associated with a grea-ter incidence of respiratory depression (P<0.05) ,less postoperative restlessness ,nausea and vomiting (P<0.05);Compared with laryn-geal mask ,sacral hemp wake times earlier ,anesthesia costs less than the control group (P<0.05);Laryngeal mask group placement suc-cess rate of close to 100% ,and sacral hemp group has failed to close to 8% of the anesthesia or the effect is not perfect ,need to change of ketamine intravenous anesthesia or general anesthesia .Conclusion abdominal surgery under two kinds of anesthesia for children ,have their respective advantages and disadvantages ,should according to their own good ,pediatric anesthesiologists situation ,operation scope and duration ,flexible application of tw o kinds of anesthesia .
