CAJ | 학술논문

目的：探讨七氟醚复合舒芬太尼麻醉诱导对小儿气管插管的影响。方法选取本院2013年6月~2014年5月的60例行气管插管患儿作为研究对象，随机分为S、P、K组，各20例。S组给予七氟醚复合舒芬太尼麻醉，P组给予丙泊酚复合芬太尼静脉注射麻醉，K组静脉注射氯胺酮麻醉。观察3组不同时间段的心率(HR)、平均动脉压(MAP)和血氧饱和度(SpO2)。比较3组停用麻醉药至呼吸恢复、清醒、拔出气管导管的时间以及术后躁动、气道并发症发生率。结果 S组T1、T2、T3、T4、T5时的SpO2、MAP、HR水平显著优于P组和K组，差异有统计学意义(P<0.05)。 S组T0时的SpO2水平显著高于P组和K组，差异有统计学意义(P<0.05)。 P组和K组各时间段的SpO2、MAP、HR水平，差异无统计学意义(P>0.05)。 S组的清醒时间、呼吸恢复时间、拔管时间显著短于P组和K组，差异有统计学意义(P<0.01)。P组和K组的呼吸恢复时间、清醒时间、拔管时间比较，差异无统计学意义(P>0.05)。S组的术后躁动、气道并发症发生率显著低于P组和K组，差异有统计学意义(P<0.05)。 P组和K组的术后躁动、气道并发症发生率比较，差异无统计学意义(P>0.05)。结论七氟醚复合舒芬太尼麻醉诱导在小儿气管插管术中的效果显著，患儿术中生命体征稳定，镇静、镇痛效果较佳，起效迅速，术后苏醒快，影响较小，值得临床推广应用。
목적：탐토칠불미복합서분태니마취유도대소인기관삽관적영향。방법선취본원2013년6월~2014년5월적60례행기관삽관환인작위연구대상，수궤분위S、P、K조，각20례。S조급여칠불미복합서분태니마취，P조급여병박분복합분태니정맥주사마취，K조정맥주사록알동마취。관찰3조불동시간단적심솔(HR)、평균동맥압(MAP)화혈양포화도(SpO2)。비교3조정용마취약지호흡회복、청성、발출기관도관적시간이급술후조동、기도병발증발생솔。결과 S조T1、T2、T3、T4、T5시적SpO2、MAP、HR수평현저우우P조화K조，차이유통계학의의(P<0.05)。 S조T0시적SpO2수평현저고우P조화K조，차이유통계학의의(P<0.05)。 P조화K조각시간단적SpO2、MAP、HR수평，차이무통계학의의(P>0.05)。 S조적청성시간、호흡회복시간、발관시간현저단우P조화K조，차이유통계학의의(P<0.01)。P조화K조적호흡회복시간、청성시간、발관시간비교，차이무통계학의의(P>0.05)。S조적술후조동、기도병발증발생솔현저저우P조화K조，차이유통계학의의(P<0.05)。 P조화K조적술후조동、기도병발증발생솔비교，차이무통계학의의(P>0.05)。결론칠불미복합서분태니마취유도재소인기관삽관술중적효과현저，환인술중생명체정은정，진정、진통효과교가，기효신속，술후소성쾌，영향교소，치득림상추엄응용。
Objective To explore the influence of sevoflurane combined with sufentanil as anesthesia induction on pe-diatric endotracheal intubation. Methods 60 endotracheal intubation children patients from June 2013 to March 2014 in our hospital were selected and randomly divided into group S,group P and group K,20 cases in each group.Group S was given sevoflurane combined with sufentanil,group P was given propofol combined with fentanyl intravenous injec-tion,group K was given intravenous ketamine.The level of the heart rate (HR),mean arterial pressure(MAP),oxyhe-moglobin saturation(SpO2)in different period among three groups was observed.The time of stopping use anesthetics to restore breathing,awake time,the time of pulling out the endotracheal tube,the occurrence rate of postoperative agitation and airway complication among three groups was compared. Results The level of SpO2、MAP、HR at the period of T1,T2, T3,T4,T5 in group S was better than that in group P and group K,with significant difference (P<0.05).The level of SpO2 at the period of T0 in group S was higher than that in group P and group K,with significant difference (P<0.05).There was no significant difference in the level of SpO2、MAP、HR at the different time periods between group P and group K (P>0.05).The time of stopping use anesthetics to restore breathing,awake time,the time of pulling out the endotracheal tube in group S was shorter than that in group P and group K,with significant difference (P<0.05).There was no significant difference in the time of stopping use anesthetics to restore breathing,awake time,the time of pulling out the endotra-cheal tube between group P and group K (P>0.05).The occurrence rate of postoperative agitation and airway complica-tion in group S was lower than that in group P and group K,with significant difference (P<0.05).There was no significant difference in the occurrence rate of postoperative agitation and airway complication between group P and group K (P>0.05). Conclusion The effect of sevoflurane combined with sufentanil as anesthesia induction in pediatric endotracheal intubation is significant.The vital signs during operatin of children patients is table,sedation and analgesia effect is bet-ter,which has the advantages of rapid onset,rapid recovery and less influence,it is worthy of promotion and application.