CAJ | 학술논문

目的：探讨不同麻醉方法在颈淋巴结结核手术中的应用。方法选取成都市公共卫生临床医疗中心2012年3月至2013年9月收治的100例颈淋巴结结核患者，随机分为两组（A、B组），A组分别静脉注射瑞芬太尼（0．5～1μg／kg）和异丙酚（0．3～0．4mg／kg）维持麻醉，B组分别静脉注射氯胺酮（1～2mg／kg）和异丙酚（0．3～0．4 mg／kg）维持麻醉，比较两组患者术中脉搏血氧饱和度（SpO2）、收缩压（SBP）、舒张压（DBP）、心率（HR），术毕苏醒情况及不良反应等指标。结果 A组患者SBP、DBP、HR和SpO2在诱导后、切皮时、搔刮病灶期间、手术结束时与入室时比较，差异无统计学意义（P＞0．05）；B组患者SBP、DBP、HR和SpO2在诱导后、切皮时、搔刮病灶期间、手术结束时与入室时比较，差异有统计学意义（P＜0．05）；与B组相比，A组患者苏醒时间明显缩短，不良反应发生率降低70％以上，术毕5 min Aldert评分明显高于B组（P＜0．05）。结论瑞芬太尼复合异丙酚和氯胺酮复合异丙酚均可用于颈淋巴结结核的手术麻醉，而前者麻醉效果及安全性均优于后者。
목적：탐토불동마취방법재경림파결결핵수술중적응용。방법선취성도시공공위생림상의료중심2012년3월지2013년9월수치적100례경림파결결핵환자，수궤분위량조（A、B조），A조분별정맥주사서분태니（0．5～1μg／kg）화이병분（0．3～0．4mg／kg）유지마취，B조분별정맥주사록알동（1～2mg／kg）화이병분（0．3～0．4 mg／kg）유지마취，비교량조환자술중맥박혈양포화도（SpO2）、수축압（SBP）、서장압（DBP）、심솔（HR），술필소성정황급불량반응등지표。결과 A조환자SBP、DBP、HR화SpO2재유도후、절피시、소괄병조기간、수술결속시여입실시비교，차이무통계학의의（P＞0．05）；B조환자SBP、DBP、HR화SpO2재유도후、절피시、소괄병조기간、수술결속시여입실시비교，차이유통계학의의（P＜0．05）；여B조상비，A조환자소성시간명현축단，불량반응발생솔강저70％이상，술필5 min Aldert평분명현고우B조（P＜0．05）。결론서분태니복합이병분화록알동복합이병분균가용우경림파결결핵적수술마취，이전자마취효과급안전성균우우후자。
Objective To investigate the effect of different anesthetic methods in the cervical lymph node tu‐berculosis operation .Methods A total of 100 patients with cervical lymph node tuberculosis in the Public Health Clinical Center of Chengdu from Mar .2012 to Sep .2013 were enrolled in this study and randomly divided into two groups (group A and B) .Patients in group A were treated with intravenous injection of remifentanil (0 .5-1 μg/kg) and propofol (0 .3-0 .4 mg/kg) ,and patients in group B were treated with intravenous injection of ketamine (1-2 mg/kg) and propofol (0 .3-0 .4 mg/kg) .The systolic pressure (SBP) ,diastolic pressure (DBP) ,heart rate (HR) , oxygen saturation (SpO2 ) ,quality of postoperative recovery and untoward reactions were recorded and analyzed .Re‐sults In group A ,there were no statistical differences of SBP ,DBP ,HR and SpO2 levels on T2 ,T3 ,T4 and T5 com‐pared with that on T1(P>0 .05) .In group B ,there were significant differences of SBP ,DBP ,HR and SpO2 levels on T2 ,T3 ,T4 and T5 compared with that on T1(P<0 .05) .Compared with group B ,the recovery time of group A was significantly decreased and the incidence of untoward reactions was decreased 70% (P<0 .05) .And the 5 min after operation Aldert Score in group A was significantly higher than that in group B(P<0 .05) .Conclusion Remifentanil combined with propofol and ketamine combined with propofol both could be used in cervical lymph node tuberculosis operation ,and the anesthetic effect of remifentanil combined with propofol could be better and safer than ketamine combined with propofol .