中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2014年
6期
753-756
,共4页
熊雨美%洪燕%梁妤婷%李佩青%朱翠平%田航
熊雨美%洪燕%樑妤婷%李珮青%硃翠平%田航
웅우미%홍연%량여정%리패청%주취평%전항
腰椎穿刺术%七氟烷%儿童
腰椎穿刺術%七氟烷%兒童
요추천자술%칠불완%인동
Lumbar puncture%Sevoflurane%Child
目的：观察短暂吸入七氟烷用于小儿腰椎穿刺术的镇静效果。方法选择2013年2月至2014年2月于广州市妇女儿童医疗中心拟行腰椎穿刺术的113例患儿为研究对象,按照术前镇静方式的不同,将其分为采用吸入七氟烷麻醉镇静的 S 组(n=58)和采用静脉输注地西泮镇静的 D 组(n=55)。本研究遵循的程序符合广州市妇女儿童医疗中心人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书。两组患儿的年龄、性别、病情程度等一般临床资料比较,差异无统计学意义(P >0.05)。常规监测两组患儿生命体征,记录穿刺时间、一次性穿刺成功率及总穿刺成功率,记录麻醉或镇静过程中体动反抗等不良反应。结果①S 组患儿 T2时刻心率显著增快,与本组 T1时刻心率比较,差异有统计学意义(t =-6.39,P <0.05)；D 组患儿 T3、T4时刻心率显著增快,与本组 T1时刻心率比较,差异也有统计学意义(t =8.80,6.82；P <0.05)；两组患儿 T2、T3、T4时刻心率比较,差异有统计学意义(t=4.909,-13.382,-12.733；P <0.01)。②D 组患儿 T3时刻的血氧饱和度(Sp O 2)较本组其他3个观察时刻明显下降,前者分别与后3者比较,差异均有统计学意义(t =-7.70,-7.74,-7.91；P <0.05)。两组患儿 T3时刻的 Sp O2比较,差异也有统计学意义(t =8.141；P <0.01)。③S 组58例患儿在局部麻醉及腰椎穿刺术过程中无一例发生体动反应,放弃操作患儿为1例(1.7%)；D 组出现体动反应为40例(72.7%),放弃操作患儿为8例(14.5%)。④S 组的一次性穿刺成功率和总穿刺成功率分别为86.2%和98.3%,而 D 组分别为65.5%和85.5%,两组比较,差异均有统计学意义(P <0.05)。⑤S 组穿刺时间为(7.6±2.1)min,D 组为(16±8.7)min,两组比较,差异也有统计学意义(P <0.05)。⑥S 组患儿吸入七氟烷后的入睡时间为(78.3±21.4)s,苏醒时间为(7.3±2.1)mm。结论短暂吸入七氟烷进行腰椎穿刺术的镇静,可提高一次性穿刺成功率和总穿刺成功率,缩短穿刺时间,减少体动反应所致的潜在神经损伤。
目的：觀察短暫吸入七氟烷用于小兒腰椎穿刺術的鎮靜效果。方法選擇2013年2月至2014年2月于廣州市婦女兒童醫療中心擬行腰椎穿刺術的113例患兒為研究對象,按照術前鎮靜方式的不同,將其分為採用吸入七氟烷痳醉鎮靜的 S 組(n=58)和採用靜脈輸註地西泮鎮靜的 D 組(n=55)。本研究遵循的程序符閤廣州市婦女兒童醫療中心人體試驗委員會所製定的倫理學標準,得到該委員會批準,分組徵得受試對象鑑護人的知情同意,併與之籤署臨床研究知情同意書。兩組患兒的年齡、性彆、病情程度等一般臨床資料比較,差異無統計學意義(P >0.05)。常規鑑測兩組患兒生命體徵,記錄穿刺時間、一次性穿刺成功率及總穿刺成功率,記錄痳醉或鎮靜過程中體動反抗等不良反應。結果①S 組患兒 T2時刻心率顯著增快,與本組 T1時刻心率比較,差異有統計學意義(t =-6.39,P <0.05)；D 組患兒 T3、T4時刻心率顯著增快,與本組 T1時刻心率比較,差異也有統計學意義(t =8.80,6.82；P <0.05)；兩組患兒 T2、T3、T4時刻心率比較,差異有統計學意義(t=4.909,-13.382,-12.733；P <0.01)。②D 組患兒 T3時刻的血氧飽和度(Sp O 2)較本組其他3箇觀察時刻明顯下降,前者分彆與後3者比較,差異均有統計學意義(t =-7.70,-7.74,-7.91；P <0.05)。兩組患兒 T3時刻的 Sp O2比較,差異也有統計學意義(t =8.141；P <0.01)。③S 組58例患兒在跼部痳醉及腰椎穿刺術過程中無一例髮生體動反應,放棄操作患兒為1例(1.7%)；D 組齣現體動反應為40例(72.7%),放棄操作患兒為8例(14.5%)。④S 組的一次性穿刺成功率和總穿刺成功率分彆為86.2%和98.3%,而 D 組分彆為65.5%和85.5%,兩組比較,差異均有統計學意義(P <0.05)。⑤S 組穿刺時間為(7.6±2.1)min,D 組為(16±8.7)min,兩組比較,差異也有統計學意義(P <0.05)。⑥S 組患兒吸入七氟烷後的入睡時間為(78.3±21.4)s,囌醒時間為(7.3±2.1)mm。結論短暫吸入七氟烷進行腰椎穿刺術的鎮靜,可提高一次性穿刺成功率和總穿刺成功率,縮短穿刺時間,減少體動反應所緻的潛在神經損傷。
목적：관찰단잠흡입칠불완용우소인요추천자술적진정효과。방법선택2013년2월지2014년2월우엄주시부녀인동의료중심의행요추천자술적113례환인위연구대상,안조술전진정방식적불동,장기분위채용흡입칠불완마취진정적 S 조(n=58)화채용정맥수주지서반진정적 D 조(n=55)。본연구준순적정서부합엄주시부녀인동의료중심인체시험위원회소제정적윤리학표준,득도해위원회비준,분조정득수시대상감호인적지정동의,병여지첨서림상연구지정동의서。량조환인적년령、성별、병정정도등일반림상자료비교,차이무통계학의의(P >0.05)。상규감측량조환인생명체정,기록천자시간、일차성천자성공솔급총천자성공솔,기록마취혹진정과정중체동반항등불량반응。결과①S 조환인 T2시각심솔현저증쾌,여본조 T1시각심솔비교,차이유통계학의의(t =-6.39,P <0.05)；D 조환인 T3、T4시각심솔현저증쾌,여본조 T1시각심솔비교,차이야유통계학의의(t =8.80,6.82；P <0.05)；량조환인 T2、T3、T4시각심솔비교,차이유통계학의의(t=4.909,-13.382,-12.733；P <0.01)。②D 조환인 T3시각적혈양포화도(Sp O 2)교본조기타3개관찰시각명현하강,전자분별여후3자비교,차이균유통계학의의(t =-7.70,-7.74,-7.91；P <0.05)。량조환인 T3시각적 Sp O2비교,차이야유통계학의의(t =8.141；P <0.01)。③S 조58례환인재국부마취급요추천자술과정중무일례발생체동반응,방기조작환인위1례(1.7%)；D 조출현체동반응위40례(72.7%),방기조작환인위8례(14.5%)。④S 조적일차성천자성공솔화총천자성공솔분별위86.2%화98.3%,이 D 조분별위65.5%화85.5%,량조비교,차이균유통계학의의(P <0.05)。⑤S 조천자시간위(7.6±2.1)min,D 조위(16±8.7)min,량조비교,차이야유통계학의의(P <0.05)。⑥S 조환인흡입칠불완후적입수시간위(78.3±21.4)s,소성시간위(7.3±2.1)mm。결론단잠흡입칠불완진행요추천자술적진정,가제고일차성천자성공솔화총천자성공솔,축단천자시간,감소체동반응소치적잠재신경손상。
Objective To observe the effect of short-term sevoflurane anesthesia for lumbar puncture in children.Methods From February 2013 to February 2014,1 13 children who underwent lumbar puncture in Guangzhou Women and Children′s Medical Center were included in the study.They were divided into group S (sevoflurane inhaled,n=58)and group D(diazepam injection,n=55)according to different ways of sedation.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangzhou Women and Children′s Medical Center.Informed consent was obtained from each participants′parents.No significant difference was found in general clinical data such as age,sex and degree of illness between two groups (P > 0.05 ).The vital signs were observed in both groups.The duration of lumbar puncture,one-time puncture success rate and total success rate of puncture were recorded.The adverse events such as body movement during the operation were also recorded.Results ① Heart rate at T2 was obviously higher than that of T1 in group S(t = - 6.39,P <0.05 ).Heart rates at T3 ,T4 were also higher than T1 in group D(t=8.8,6.82;P <0.05).There were significant differences in heart rate at T2 ,T3 ,T4 between two groups(t=4.909,-13.382,-12.733;P <0.01).②Compared with the other observing time, blood oxygen saturation (Sp O2 )at T3 was decreased obviously in group D(t=-7.70,-7.74,-7.91;P <0.05).There was significant difference in Sp O2 at T3 between two groups(t =8.141,P <0.01).③No one had body movement during the operation in group S,and 1 case quited the operation(1.7%).forty cases (72.7%)had body movement during the operation in group D,and 8 cases quited the operation(14.5%).④There were significant differences in one-time puncture success rate and total puncture success rate between two groups (P <0.05).⑤The duration of lumbar puncture in group S was (7.6±2.1)min,which was obviously shorter than (1 6.0±8.7)min of group D(P <0.05).⑥ The anesthesia time was (78.3 ± 21.4)s and recovery time was (7.3±2.1)min ingroup S.Conclusions Short-term sevoflurane anesthesia can improve one-time puncture success rate and shorten the duration of the lumbar puncture.It also can reduce the potential nerve damage.
