CAJ | 학술논문

【目的】评价瑞芬太尼联合异丙酚靶控输注应用于小儿纤维支气管镜检查麻醉中临床效果。【方法】选取2012年9月至2013年10月在本院择期行纤维支气管镜检查患儿60例,根据随机数字表分为联合组和对照组,联合组采取瑞芬太尼联合异丙酚靶控输注静脉全麻,对照组采取利多卡因局麻复合七氟醚全麻。比较两组患儿麻醉效果,记录两组患儿给药前(T1)、纤维支气管镜放入1 min(T2)、纤维支气管镜取出前(T3)和苏醒时(T4)心率、收缩压和舒张压变化情况,记录两组患儿不良反应发生情况。【结果】联合组患儿麻醉总有效率为96.7%,与对照组93.3%比较差异无统计学意义(P >0.05)；与 T1时刻相比,两组患者 T2、T3时刻心率和血压均降低,T4时刻升高,差异均具有统计学意义(P <0.05)；T2和 T3时刻,联合组患者心率和血压均高于对照组(P <0.05),T4时刻,联合组患者心率和血压均低于对照组(P <0.05)；联合组患者喉痉挛、恶心呕吐和烦躁等不良反应发生率均低于对照组(P <0.05)。【结论】瑞芬太尼联合异丙酚靶控输注麻醉应用于小儿纤维支气管镜检查具有良好的麻醉效果,对心血管系统影响较小,不良反应少,是一种安全有效的麻醉方式。
【목적】평개서분태니연합이병분파공수주응용우소인섬유지기관경검사마취중림상효과。【방법】선취2012년9월지2013년10월재본원택기행섬유지기관경검사환인60례,근거수궤수자표분위연합조화대조조,연합조채취서분태니연합이병분파공수주정맥전마,대조조채취리다잡인국마복합칠불미전마。비교량조환인마취효과,기록량조환인급약전(T1)、섬유지기관경방입1 min(T2)、섬유지기관경취출전(T3)화소성시(T4)심솔、수축압화서장압변화정황,기록량조환인불량반응발생정황。【결과】연합조환인마취총유효솔위96.7%,여대조조93.3%비교차이무통계학의의(P >0.05)；여 T1시각상비,량조환자 T2、T3시각심솔화혈압균강저,T4시각승고,차이균구유통계학의의(P <0.05)；T2화 T3시각,연합조환자심솔화혈압균고우대조조(P <0.05),T4시각,연합조환자심솔화혈압균저우대조조(P <0.05)；연합조환자후경련、악심구토화번조등불량반응발생솔균저우대조조(P <0.05)。【결론】서분태니연합이병분파공수주마취응용우소인섬유지기관경검사구유량호적마취효과,대심혈관계통영향교소,불량반응소,시일충안전유효적마취방식。
[Objective]To investigate the application effect of remifentanil combined with propofol by tar-get controlled infusion anesthesia in pediatric fiberoptic bronchoscopy.[Methods]60 cases of children undergo-ing fiberoptic bronchoscopy in our hospital were selected from September 2012 to October 2013.All cases were randomly divided into combined group and control group according to random number table.Cases in combined group were taken remifentanil combined with propofol by target controlled infusion anesthesia,while in the control group were taken lidocaine for local anesthesia combined with sevoflurane for general anesthesia.The anesthetic effects of the two groups were compared.Before administration (T1 ),bronchoscopy into the 1 min (T2 ),before bronchoscopy removed (T3 )and awakening (T4 ),the heart rate,systolic and diastolic blood pressure changing situations were recorded.The adverse reactions of the two groups were recorded.[Results]The total anesthesia effective rate of combined group was 96.7%,compared with the control group having no significant difference (P >0.05).Compared with the T1 moment,at T2 and T3 moment,the heart rates and blood pressures of the two groups were decreased,at T3 moment were increased,the differenced were statisti-cally significant (P <0.05).At T2 and T3 moment,the heart rate and blood pressure of the combined group were higher than the control group (P <0.05).At T4 moment,the heart rate and blood pressure of the com-bined group were lower than the control group (P <0.05).The laryngospasm,nausea,vomiting and irritabil-ity and other adverse reactions rates in the combined group were lower than the control group (P <0.05 ).[Conclusion]Remifentanil combined with propofol by target controlled infusion anesthesia used in pediatric bronchoscopy had good anesthetic effects,little effect on the cardiovascular system and fewer adverse reac-tions.It was a safe and effective anesthesia method.