CAJ | 학술논문

目的：探讨瑞芬太尼联合七氟醚吸入在新生儿腹部手术全身麻醉中的临床效果和安全性。方法选取该院2013年6月至2014年6月收治的需全身麻醉行腹部手术的新生儿50例，随机分为观察组和对照组各25例。对照组患儿吸入七氟醚诱导和维持麻醉，观察组患儿在对照组基础上接受瑞芬太尼静脉泵注。比较入室时（T1）、插管前即刻（T2）、手术开始10 min（T3）、手术开始1 h（T4）、拔管时（T5）的心率（HR）、平均动脉压（MAP）和七氟醚浓度，同时比较两组患儿的一次插管成功率和不良反应。结果 T3、T4和T5时观察组患儿HR低于对照组，T3时观察组患儿MAP显著低于对照组，T2、T3和T4时观察组患儿七氟醚浓度低于对照组，差异均有统计学意义（P＜0.01）。观察组患儿一次插管成功率显著高于对照组，不良反应发生率低于对照组，差异均有统计学意义（P＜0.05）。结论瑞芬太尼联合七氟醚吸入在新生儿腹部手术全身麻醉中可提供良好的麻醉效果，且能够提高患儿一次插管成功率并降低不良反应发生率。
목적：탐토서분태니연합칠불미흡입재신생인복부수술전신마취중적림상효과화안전성。방법선취해원2013년6월지2014년6월수치적수전신마취행복부수술적신생인50례，수궤분위관찰조화대조조각25례。대조조환인흡입칠불미유도화유지마취，관찰조환인재대조조기출상접수서분태니정맥빙주。비교입실시（T1）、삽관전즉각（T2）、수술개시10 min（T3）、수술개시1 h（T4）、발관시（T5）적심솔（HR）、평균동맥압（MAP）화칠불미농도，동시비교량조환인적일차삽관성공솔화불량반응。결과 T3、T4화T5시관찰조환인HR저우대조조，T3시관찰조환인MAP현저저우대조조，T2、T3화T4시관찰조환인칠불미농도저우대조조，차이균유통계학의의（P＜0.01）。관찰조환인일차삽관성공솔현저고우대조조，불량반응발생솔저우대조조，차이균유통계학의의（P＜0.05）。결론서분태니연합칠불미흡입재신생인복부수술전신마취중가제공량호적마취효과，차능구제고환인일차삽관성공솔병강저불량반응발생솔。
Objective To investigate the clinic effect and safety of remifentanil combined with sevoflurance anesthesia in neonates with abdominal surgery. Methods A total of 50 neonates with abdominal surgery under general anesthesia in this hospital from June 2013 to June 2014 were randomly divided into the observation group and the control group ,25 of each group. The children patients in the control group were induced and maintained with sevoflurane while the observation group with remifentanil based on the observation group. The HR,MAP and sevoflurane concentration were observed at baseline (T1),before intubation(T2) and at 10 min(T3),60 min(T4) after incision,and during the extubation(T5). The disposable intubation success rate and adverse reactions of the two groups were also compared. Results The HRs at T3,T4,and T5 time points of the observation group were lower than those of the control group. The sevoflurance concentrations at T 2,T3,and T4 were lower than those of the control group,and the difference were statistically significant(P<0.05). Disposable intubation success rate of the observation group was higher than that of the control group while the incidence of adverse reactions was lower than that of the control group ,whose difference was statistically significant(P<0.05). Conclusion Remifentanil combined with sevoflurane may provide satisfactory anesthetic effect in neonates with abdominal surgery ,improving disposable intubation success rate while lowering the occurrence of adverse reactions. reducing inhalational anesthetic and less side effects.