CAJ | 학술논문

目的：研究氯胺酮复合七氟醚行非气管插管全麻在儿科手术中的应用价值以及安全性。方法：选取某院2012年2月～2014年2月期间满足非气管插管全麻条件的患儿共120例，以抽签法随机分为观察组与对照组，两组均为60例，对照组采用单纯氯胺酮静脉麻醉法，观察组采取氯胺酮静脉麻醉复合七氟醚麻醉方式，对比两组患儿在麻醉诱导期、手术切片期以及苏醒期的平均动脉压、心率以及动脉血氧饱和度，同时就不良症状研究两组患儿用药的安全性。结果：麻醉诱导期观察组的平均动脉压以及心率均显著低于对照组，差异有统计学意义（P＜0.05），观察组共出现6例不良症状，包括呼吸道分泌物增多2例、呼吸抑制1例、苏醒期躁动2例、苏醒延迟1例，不良反应出现率为10%；观察组呼吸道分泌物增多10例，呼吸抑制4例，苏醒期躁动7例，苏醒延迟8例，不良反应出现率48.33%，观察组不良症状出现率明显低于对照组，差异有统计学意义（P＜0.05）。结论：氯胺酮复合七氟醚应用于儿科手术可以保证患儿血流动力学的稳定，抑制不良反应的出现，在临床中具有较好的推广价值。
목적：연구록알동복합칠불미행비기관삽관전마재인과수술중적응용개치이급안전성。방법：선취모원2012년2월～2014년2월기간만족비기관삽관전마조건적환인공120례，이추첨법수궤분위관찰조여대조조，량조균위60례，대조조채용단순록알동정맥마취법，관찰조채취록알동정맥마취복합칠불미마취방식，대비량조환인재마취유도기、수술절편기이급소성기적평균동맥압、심솔이급동맥혈양포화도，동시취불량증상연구량조환인용약적안전성。결과：마취유도기관찰조적평균동맥압이급심솔균현저저우대조조，차이유통계학의의（P＜0.05），관찰조공출현6례불량증상，포괄호흡도분비물증다2례、호흡억제1례、소성기조동2례、소성연지1례，불량반응출현솔위10%；관찰조호흡도분비물증다10례，호흡억제4례，소성기조동7례，소성연지8례，불량반응출현솔48.33%，관찰조불량증상출현솔명현저우대조조，차이유통계학의의（P＜0.05）。결론：록알동복합칠불미응용우인과수술가이보증환인혈류동역학적은정，억제불량반응적출현，재림상중구유교호적추엄개치。
Objectives:To find out the application value and safety of applying non-general anesthesia with tracheal intubation with Ketamine combined to sevoflurane in pediatric surgeries. Methods:120 cases of children who suited the conditions to non-general anesthesia with tracheal intubation accepted by our hospital during February 2012 to February 2014 were selected as the research objects. They were divided into two groups with the draw method, each group has 60 cases of children. In which the control group adopted pure ketamine intravenous anesthesia method, while the observation group took ketamine intravenous anesthesia compound sevoflurane anesthesia. Everyone’s mean arterial pressure, heart rate and arterial blood oxygen saturation in the period of anesthesia induction, surgical biopsy and awakening were recorded and compared. The drug adverse symptoms of each group were also compared in order to find out the safety of each method. Results:Anesthesia induction period mean arterial pressure and heart rate in observation group were significantly lower than the control group, the difference showde statistically significant (P<0.05). In the observation group, there was a total of 6 cases of adverse symptoms, including 2 cases of respiratory secretions increase, 1 cases of respiratory inhibition, 2 cases of awakening period agitation, delayed awakening in 1 case, the adverse reactions occur at a rate of 10%. While in the observation group, there were 10 cases of respiratory secretions increase, 4 cases of respiratory depression;awakening period of agitation in 7 cases, delays in 8 cases, the adverse reaction rate was 48.33%. The rate of adverse symptoms in observation group was obviously lower than that of the control group, the difference showed statistically significant (P<0.05). Conclusions:Ketamine combined with sevoflurane used in pediatric surgery can ensure children with hemodynamic stability, suppress the occurrence of adverse reactions. It has good popularization value in clinical.