CAJ | 학술논문

目的：观察右美托咪定复合舒芬太尼在儿童纤维结肠镜检查中的麻醉效果及安全性。方法选择行纤维结肠镜检查的患儿40例，ASAⅠ或Ⅱ级，年龄10～15岁。随机分为右美托咪定复合舒芬太尼组（D 组）和丙泊酚复合舒芬太尼组（P 组），每组20例。两组均先静脉注射舒芬太尼0.1μg／kg 后，D 组10 min 内泵入右美托咪定1μg／kg，再持续泵入右美托咪定1μg·kg －1·h －1。P 组静脉注射丙泊酚2 mg／kg 后，持续泵入丙泊酚6 mg·kg －1·h －1。对两组麻醉效果进行评级，观察两组给药前（T0）、给药10 min 后（T1）、入肛门时（T2）、至回盲部时（T3）HR、MAP 和 SpO2的变化，记录苏醒时间及麻醉后不良反应情况。结果D 组麻醉效果优于 P 组（P ＜0.05）。T1时两组 HR、MAP 均明显低于 T0（P ＜0.05），P 组 SpO2在 T1、T2、T3时明显低于 D 组和 T0（P ＜0.05）。T2、T3时 D 组 HR 慢于 P 组和 T0（P ＜0.05）。P 组苏醒时间长于 D 组（P ＜0.05）。P 组术中舌后坠和呼吸抑制的发生率明显高于 D 组（P ＜0.05）。结论右美托咪定复合舒芬太尼用于儿童纤维结肠镜检查较安全，且麻醉效果满意。
목적：관찰우미탁미정복합서분태니재인동섬유결장경검사중적마취효과급안전성。방법선택행섬유결장경검사적환인40례，ASAⅠ혹Ⅱ급，년령10～15세。수궤분위우미탁미정복합서분태니조（D 조）화병박분복합서분태니조（P 조），매조20례。량조균선정맥주사서분태니0.1μg／kg 후，D 조10 min 내빙입우미탁미정1μg／kg，재지속빙입우미탁미정1μg·kg －1·h －1。P 조정맥주사병박분2 mg／kg 후，지속빙입병박분6 mg·kg －1·h －1。대량조마취효과진행평급，관찰량조급약전（T0）、급약10 min 후（T1）、입항문시（T2）、지회맹부시（T3）HR、MAP 화 SpO2적변화，기록소성시간급마취후불량반응정황。결과D 조마취효과우우 P 조（P ＜0.05）。T1시량조 HR、MAP 균명현저우 T0（P ＜0.05），P 조 SpO2재 T1、T2、T3시명현저우 D 조화 T0（P ＜0.05）。T2、T3시 D 조 HR 만우 P 조화 T0（P ＜0.05）。P 조소성시간장우 D 조（P ＜0.05）。P 조술중설후추화호흡억제적발생솔명현고우 D 조（P ＜0.05）。결론우미탁미정복합서분태니용우인동섬유결장경검사교안전，차마취효과만의。
Objetive To observe the effect and safety of using sufentanil with dexmedetomidine in colonoscopy in children.Methods Forty children (ASAⅠorⅡ,aged 1 0 ~1 5 years)undergoing colonscopy were randomly devided into two groups,with 20 children in each.Group D were injected sufentanil with dexmedetomidine and group P were injected propofol with dexmedetomidine.The scale of anesthetic effect, HR,MAP,and SpO2 at pre-injection(T0 ),1 0 min after injection(T1 ),when colonoscopy was put into the anus(T2 ),when colonoscopy was put to the ileocecal junction(T3 )were documented.The time of recovery and complication after anesthesia were recorded.Results The anesthetic effect in group D was better than in group P(P <0.05 ).In two groups,HR,MAP at T1 were lower than at T0 (P <0.05).In group P,SpO2 at T1 ,T2 ,T3 were lower than in group D and at T0 (P <0.05).In group D,HR at T2 ,T3 were lower than in group P and at T0 (P <0.05).The time of recovery in group P was longer than that in group D(P <0.05 ).The complication of glossocoma and respiratory depression in group P was higher than in group D(P <0.05 ). Conclusions The anesthetic effect of dexmedetomidine combined with sufentanil in children undergoing colons-copy is satisfactory and safe.