中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
15期
44-46,47
,共4页
超快通道麻醉%心脏直视手术%安全性%有效性
超快通道痳醉%心髒直視手術%安全性%有效性
초쾌통도마취%심장직시수술%안전성%유효성
Fast track anesthesia%Open heart surgery%Safety%Efficacy
目的：观察超快通道麻醉应用于小儿心脏直视手术的安全性和有效性。方法：选取2013年在本院行心脏直视手术的小儿患者80例，以随机分配原则将其分为观察组（超快通道麻醉组）与对照组（传统麻醉组），每组各40例。其中观察组患者在进入手术室后吸入七氟醚诱导，并静注舒芬太尼与爱可松行气管插管，术中以七氟醚进行维持麻醉；对照组患者进入手术室后静注异丙酚、芬太尼与爱可松行气管插管，术中以异丙酚、芬太尼进行维持麻醉。两组患者以PCV模式进行机械通气，并测定两组患者的平均动脉压（MAP）、中心静脉压（CVP）、术后拔管时间、CICU停留时间、住院费用与并发症等指标。结果：两组患者在血流动力学等指标测定上比较差异无统计学意义（P>0.05）。但观察组的术后拔管时间、CICU停留时间、住院费用均明显少于对照组，差异均有统计学意义（P<0.05）；对照组患者并发症发生率为12.5%，观察组为5.0%，两组比较差异有统计学意义（P<0.05）。结论：心脏超快通道麻醉具有较高的安全性与经济性，该种麻醉方式值得在临床上广泛推广，以帮助更多小儿心脏直视手术患者受益。
目的：觀察超快通道痳醉應用于小兒心髒直視手術的安全性和有效性。方法：選取2013年在本院行心髒直視手術的小兒患者80例，以隨機分配原則將其分為觀察組（超快通道痳醉組）與對照組（傳統痳醉組），每組各40例。其中觀察組患者在進入手術室後吸入七氟醚誘導，併靜註舒芬太尼與愛可鬆行氣管插管，術中以七氟醚進行維持痳醉；對照組患者進入手術室後靜註異丙酚、芬太尼與愛可鬆行氣管插管，術中以異丙酚、芬太尼進行維持痳醉。兩組患者以PCV模式進行機械通氣，併測定兩組患者的平均動脈壓（MAP）、中心靜脈壓（CVP）、術後拔管時間、CICU停留時間、住院費用與併髮癥等指標。結果：兩組患者在血流動力學等指標測定上比較差異無統計學意義（P>0.05）。但觀察組的術後拔管時間、CICU停留時間、住院費用均明顯少于對照組，差異均有統計學意義（P<0.05）；對照組患者併髮癥髮生率為12.5%，觀察組為5.0%，兩組比較差異有統計學意義（P<0.05）。結論：心髒超快通道痳醉具有較高的安全性與經濟性，該種痳醉方式值得在臨床上廣汎推廣，以幫助更多小兒心髒直視手術患者受益。
목적：관찰초쾌통도마취응용우소인심장직시수술적안전성화유효성。방법：선취2013년재본원행심장직시수술적소인환자80례，이수궤분배원칙장기분위관찰조（초쾌통도마취조）여대조조（전통마취조），매조각40례。기중관찰조환자재진입수술실후흡입칠불미유도，병정주서분태니여애가송행기관삽관，술중이칠불미진행유지마취；대조조환자진입수술실후정주이병분、분태니여애가송행기관삽관，술중이이병분、분태니진행유지마취。량조환자이PCV모식진행궤계통기，병측정량조환자적평균동맥압（MAP）、중심정맥압（CVP）、술후발관시간、CICU정류시간、주원비용여병발증등지표。결과：량조환자재혈류동역학등지표측정상비교차이무통계학의의（P>0.05）。단관찰조적술후발관시간、CICU정류시간、주원비용균명현소우대조조，차이균유통계학의의（P<0.05）；대조조환자병발증발생솔위12.5%，관찰조위5.0%，량조비교차이유통계학의의（P<0.05）。결론：심장초쾌통도마취구유교고적안전성여경제성，해충마취방식치득재림상상엄범추엄，이방조경다소인심장직시수술환자수익。
Objective:To determine the efficacy and safety of ultra fast track anesthesia in pediatric open heart operation.Method:80 pediatric patients undergoing open heart operation in our hospital from January 2013 to December 2013 were divided into the observation group (ultra fast track anesthesia group) and control group (traditional anesthesia group) in a random distribution principle,40 cases in each group.The patients in the observation group of the operation room were given Sevoflurane inhalation induction, intravenous Sufentanil and Aikesong followed by endotracheal intubation, anesthesia was maintained with Sevoflurane in operation; the control group patients after entering operation room were given intravenous Propofol, Fentanyl and Aikesong followed by endotracheal intubation, intraoperative propofol, fentanyl for anesthesia maintenance.The two groups of patients were given mechanical ventilation in PCV mode, then determine the mean arterial pressure (MAP), central venous pressure (CVP), CICU time, postoperative extubation time of stay, postoperative complications and cost of hospitalization of the patients in the two groups.Result:The two groups of patients had no significant difference in indexes such as the hemodynamic index (P>0.05).But the postoperative extubation time, CICU stay, hospital costs of the observation group were significantly less than that of the control group, there were significant difference between groups (P<0.05).The control group patients with complication rate was 12.5%, the observation group was 5.0%, compared the two groups was statistically significant difference (P<0.05)Conclusion:The safety and economy are higher in heart ultra fast track anesthesia.This anesthesia method is worth widely spreading in clinical in order to help more children who are undergoing open heart surgery.benefit.
