氟比洛芬酯联合七氟醚全麻在小儿先天性心脏病介入治疗中的应用  

Application of Flurbiprofen combined with sevoflurane general anaesthesia in intervening therapy for congenital heart diseases in children

作　　者：陈慧[1] 袁志会[1] 

机构地区：[1]贵州省遵义医学院附属医院麻醉科,贵州遵义563003

出　　处：《现代预防医学》2013年第14期2622-2624,2633,共4页Modern Preventive Medicine

摘　　要：目的评价小儿先天性心脏病介入封堵术中联合应用氟比洛芬酯和七氟醚全麻的临床效果。方法先天性心脏病患儿40例,随机分为两组:S组(七氟醚吸入组)和F+S组(氟比洛芬酯联合七氟醚吸入组)。观察两组患儿诱导前(T0)、气管插管时(T1)、静脉穿刺时(T2)、心内操作时(T3)、拔除气管导管时(T4)、拔除后5min(T5)、拔除后10min(T6)时的平均动脉压(MAP)、血氧饱和度(SpO2)、心率(HR),记录两组在T4～T6时间点的躁动评分和意识状态(OAA/S)评分以及术后不良反应的发生率。结果两组患儿均顺利完成介入治疗。与T0时点比较,S组在T4～T6时点HR增快、MAP明显增加(P﹤0.05);在T4～T6时点F+S组患儿与S组比较,HR明显减慢、MAP显著降低(P﹤0.05)。F+S组在各观察点的躁动评分均显著低于S组(P﹤0.05);两组在各时点的意识状态评分差异无统计学意义;术后24h随访中,S组有3例、F+S组有1例出现恶心呕吐,其他无不良反应发生。结论氟比洛芬酯联合七氟醚全麻可安全用于小儿先天性心脏病的介入治疗,值得临床推荐使用。OBJECTIVE To evaluate the efficacy of Flurbiprofen combined with sevoflurane general anaesthesia in intervening therapy for congenital heart diseases in children. METHODS 40 pediatric patients of congenital heart diseases were randomly divided into F＋S group （administration of Flurbiprofen 1.5 mg / kg before the operation, n = 20） and S group （administration of same volume of saline, n = 20）. The indexes of mean artery blood pressure （MAP）, saturation of spulse oxygen （SpO 2 ）, heart rate （HR） were monitored before anaesthesia （T0）, tracheal intubation （T1）, venepuncture （T2）, cardiac visualization （ T3） , extubation （ T4） , 5min after extubation （ T5） and 10min after extubation （ T6）. Pediatric Anesthesia Emergence Delirium （PAED） Scale, the Observer’s Assessment of Alertness / Sedation （OAA / S） Scale and the incidence of post-operation adverse reactions were recorded followed-up 24h after the operation to visit the side effects. RESULTS The interventional management was successfully completed in all patients. Compared with T0, MAP and HR were higher in two groups at T4-T6. MAP and HR at T4-T6 were apparently lower in group F＋S than in group S （P﹤0.05）. The scores of PAED Scale were lower in group F＋S than group S （P﹤0.05）. There was no statistical difference in OAA / S of two groups. The nausea and vomitting report of group S and group F＋S were 3 cases and 1 case respectively. And there was no other adverse effect. CONCLUSION Flurbiprofen compared with sevoflurane general anaesthesia is a safe anesthesia method in intervening therapy for congenital heart diseases in children and it is worthy of clinical use.

关 键 词：氟比洛芬酯 七氟醚 先天性心脏病 小儿 导管术 

分 类 号：R614[医药卫生—麻醉学]