腹股沟斜疝患儿不同麻醉微创术后不良行为比较  

Comparison of Negative Postoperative Behavior in Children with Indirect Inguinal Hernia After Minimally Invasive Surgery Under Different Anesthesia Schemes

作　　者：刘亚男[1] 孙颜 李东兴[1] LIU Yanan;SUN Yan;LI Dongxing(Department of Anesthesiology,Handan Central Hospital,Handan,Hebei,China 056000)

机构地区：[1]河北省邯郸市中心医院麻醉科,河北邯郸056000

出　　处：《中国药业》2021年第20期99-101,共3页China Pharmaceuticals

基　　金：河北省医学科学研究课题[20191849]。

摘　　要：目的比较不同麻醉方案下腹腔镜腹股沟斜疝患儿术后不良行为发生情况。方法选取医院2019年1月至2020年6月收治的腹股沟斜疝患儿90例,按随机数字表法分为S组、P组、SP组,各30例。均在腹腔镜下行腹股沟斜疝疝囊高位结扎术,术前,S组患儿予吸入麻醉,P组患儿予全凭静脉麻醉,SP组患儿予静吸复合麻醉。结果3组患儿麻醉起效时间和手术时间无显著差异(P>0.05);P组患儿拔管时间显著短于S组和SP组,且SP组短于S组;SP组患儿的清醒时间显著短于S组和P组,且P组短于S组(P<0.05);3组患儿术后1,3,7,15 d及3个月时的整体焦虑、夜间噩梦、遗尿、饮食障碍、攻击性、冷漠退缩发生率,以及术后7 d内疼痛发生率均无显著差异(P>0.05)。结论相对于吸入麻醉和全凭静脉麻醉,静吸复合麻醉用于腹腔镜下腹股沟斜疝手术患儿,术中清醒时间较短,且术后不良行为发生率相当。Objective To compare the negative postoperative behavioral changes in children with laparoscopic indirect inguinal hernia undergoing laparoscopic surgery under different anesthesia schemes.Methods A total of 90 children with indirect inguinal hernia admitted to our hospital from January 2019 to June 2020 were selected and randomly divided into groups S,P and SP according to the random number table method,30 cases in each group.All children underwent laparoscopic high ligation of indirect inguinal hernia sac.Before the surgery,children in group S were given inhalation anesthesia,children in group P were given total intravenous anesthesia,and children in group SP were given combined intravenous and inhalation anesthesia(CIIA).Results There was no significant difference in the onset-time of anesthesia or operation time among the three groups.The extubation time of children in group P was significantly shorter than that in groups S and SP,and that in group SP was shorter than that in group S.The awake time of children in SP group was significantly shorter than that in group S and group P,and that in group P was shorter than that in group S(P<0.05).Among the three groups,there was no significant difference in the incidence of overall anxiety,nightmares,enuresis,eating disorders,aggression,indifference and withdrawal at 1,3,7,15 d and 3 months after the surgery,and the incidence of pain within 7 d after the surgery(P>0.05).Conclusion Compared with inhalation anesthesia and total intravenous anesthesia,CIIA for children undergoing laparoscopic indirect inguinal hernia surgery has shorter awake time and simiar incidence of negative postoperative behavior.

关 键 词：腹股沟斜疝 儿童 腹腔镜 吸入麻醉 全凭静脉麻醉 静吸复合麻醉 不良行为 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]