骶麻复合喉罩吸入七氟醚在小儿腹腔镜疝修补术的应用效果  

Effect of Sevoflurane Inhalation by Sacral Anesthesia Combined with Laryngeal Mask in Laparoscopic Hernia Repair in Children

作　　者：高锦文[1] 邹群飞[1] 黄洁莲[1] 林美玉[1] GAO Jinwen;ZOU Qunfei;HUANG Jielian;LIN Meiyu(Jiangmen Maternal and Child Health Hospital,Jiangmen,Guangdong 529050,China)

机构地区：[1]江门市妇幼保健院,广东江门529050

出　　处：《大医生》2020年第11期21-23,共3页Doctor

基　　金：江门市卫生计生局科学技术研究项目(编号:18A103)。

摘　　要：目的观察小儿腹腔镜疝修补术中运用骶麻复合喉罩吸入七氟醚的临床效果。方法选取2017年3月至2018年5月江门市妇幼保健院收治的60例行腹腔镜疝修补术患儿为研究对象,按照随机数字表法将其分为对照组和观察组,每组30例。对照组采用丙泊酚复合芬太尼气管插管全麻治疗,观察组则采用骶麻复合喉罩吸入七氟醚治疗,对比分析两组麻醉效果。结果两组患儿不同时间段的心率(HR)水平均出现明显波动,组间比较差异无统计学意义(P>0.05);观察组在T2和T3的脉搏血氧饱和度(SpO2)水平显著高于对照组(P<0.05);观察组患儿的定向力恢复、随意运动恢复、呼之睁眼及拔管时间分别为(7.4±1.9)min、(10.2±2.4)min、(6.5±2.2)min、(7.1±2.4)min,明显低于对照组的(15.4±2.9)min、(19.4±3.1)min、(11.9±3.1)min、(12.7±3.5)min,组间比较差异有统计学意义(P<0.05);同时,术后10、30、60以及120 min时,观察组患儿的小儿麻醉苏醒躁动评分表(FAED)躁动评分分别为(1.31±0.29)分、(1.41±0.72)分、(1.44±0.39)分、(1.57±0.56)分,明显低于对照组的(2.48±0.59)分、(2.64±0.48)分、(3.11±0.48)分、(2.78±0.67)分,组间比较差异有统计学意义(P<0.05)。结论通过将骶麻复合喉罩吸入七氟醚运用在小儿腹腔镜疝修补术中,不仅可以稳定血流动力学,还能减少术后躁动,缩短术后恢复时间,有助于促进患儿康复。Objective To observe the clinical effect of sevoflurane inhalation with sacral anesthesia combined laryngeal mask in pediatric laparoscopic hernia repair.Methods A total of 60 cases of Jiangmen Maternal and Child Health Hospital from March 2017 to May 2018 were randomly divided into two groups,30 cases in each group.The control group was anesthetized with propofol combined with fentanyl,and the observation group with sacrum combined with laryngeal mask airway(LMA)was inhaled sevoflurane.Results The HR level of the two groups fluctuated significantly at different time periods,but there was no statistical significance between the two groups(P>0.05).At T2 and T3,SpO2 level of the observation group was higher than that of the control group(P<0.05).The recovery time of directional force,voluntary movement,open eyes and extubation in the observation group was(7.4±1.9)min,(10.2±2.4)min,(6.5±2.2)min and(7.1±2.4)min,respectively,which were significantly lower than that of the control group(15.4±2.9)min,(19.4±3.1)min,(11.9±3.1)min and(12.7±3.5)min,and there were significant differences between the groups(P<0.05).At the same time,at 10,30,60 and 120 min after the operation,the scores of FAED restlessness in the observation group were(1.31±0.29),(1.41±0.72),(1.44±0.39)and(1.57±0.56),which were significantly lower than those in the control group(2.48±0.59),(2.64±0.48),(3.11±0.48)and(2.78±0.67),and the comparison between the groups was statistically significant(P<0.05).Conclusion The application of sevoflurane in combination with sacral anesthesia and laryngeal mask in pediatric laparoscopic hernia repair can not only stabilize hemodynamics,but also reduce postoperative restlessness,shorten postoperative recovery time,and help to promote the recovery of children.

关 键 词：腹腔镜疝修补术 七氟醚 骶麻 喉罩 

分 类 号：R47[医药卫生—护理学]