组合式吸入麻醉诱导装置在小儿发育性髋关节脱位复位手术中的应用效果  

Application effect of combined inhalation anesthesia induction device in reduction of developmental dysplasia of the hip in children

作　　者：李凯辉 刘珊珊 蔡铁良 黎笑微 LI Kaihui;LIU Shanshan;CAI Tieliang;LI Xiaowei(Department of Anesthesiology,People′s Liberation Army Ground Force Seventy-three Military Hospital,Chenggong Hospital Affiliated to Xiamen University,Fujian Province,Xiamen 361000,China)

机构地区：[1]中国人民解放军陆军第七十三集团军医院厦门大学附属成功医院麻醉科,福建厦门361000

出　　处：《中国当代医药》2022年第18期107-110,共4页China Modern Medicine

基　　金：福建省厦门市科技计划项目(3502Z20174034)。

摘　　要：目的探讨组合式吸入麻醉诱导装置吸入七氟醚在小儿发育性髋关节脱位(DDH)手法复位手术的应用效果。方法选取2016年1月至2020年1月于中国人民解放军陆军第七十三集团军医院厦门大学附属成功医院就诊的97例发育性髋关节脱位手法复位患儿作为研究对象,采用随机数字表法分为G组(n=49)与D组(n=48)。G组在手法复位前采用组合式吸入麻醉诱导装置吸入七氟醚2 ml/次,补充剂量为七氟醚2 ml/次;D组采用三角肌注射氯胺酮4~5 mg/kg,补充剂量为氯胺酮0.5 mg/(kg·次)静脉滴注。分析与统计两组患儿麻醉前(T_(1))、手术开始前(T_(2))、术毕清醒时(T_(3))的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2)),入睡时间、清醒时间及术中不良反应总发生率。结果两组患儿T_(1)时MAP、HR、SpO_(2)比较,差异无统计学意义(P>0.05)。G组患儿T_(2)、T_(3)时MAP、HR、低于D组,差异有统计学意义(P<0.05),两组T_(2)、T_(3)的SpO_(2)比较,差异无统计学意义(P>0.05);在需要内收肌切断后手法复位的患儿中,Gg组T_(2)、T_(3)时MAP、HR低于Dd组,差异有统计学意义(P<0.05),两组T_(2)、T_(3)的SpO_(2)比较,差异无统计学意义(P>0.05)。G组患儿入睡时间长于D组,差异有统计学意义(P<0.05),清醒时间短于D组,差异有统计学意义(P<0.05)。G组患儿术中不良反应总发生率低于D组,差异有统计学意义(P<0.05)。结论小儿发育性髋关节脱位手法复位时与传统氯胺酮麻醉比较,采用组合式吸入麻醉诱导装置吸入七氟醚麻醉具有更人性化、更安全,以及诱导舒适、苏醒迅速、不良反应少等优点,是一种安全有效的麻醉方法。Objective To observe the application effect of Sevoflurane inhalation by combined inhalation anesthesia induction device in reduction developmental dysplasia of the hip(DDH)in children.Methods A total of 97 children with the diagnosis of DDH were selected from the People′s Liberation Army Ground Force Seventy-three Military Hospital,Chenggong Hospital affiliated to Xiamen University from January 2016 to January 2020,and divided into group G(n=49)and group D(n=48)by random number table method.The group G was inhaled Sevoflurane 2 ml once by using combined inhalation anesthesia induction device before manual reduction with the supplementary dose of Sevoflurane 2 ml once,and group D was injected Ketamine 4-5 mg/kg through deltoid muscle with the supplementary dose of 0.5 mg/kg intravenously.The mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO_(2)),sleeping latency,wakening time,and the total incidence of adverse events were collected and analyzed at pre-anesthesia(T_(1)),pre-operation(T_(2)),and post-operation(T_(3)).Results There were no significant differences in MAP,HR and SpO_(2)between the two groups at T_(1)(P>0.05).The fluctuation of MAP,HR in group G at T_(2) and T_(3) were lower than those in group D,with statistically differences(P<0.05).There were no significant differences in SpO_(2)at T_(2) and T_(3) between group G and group D(P>0.05).The fluctuation of MAP,HR in group Gg at T_(2) and T_(3) were lower than those in group Dd in children of who required manual reduction after adductor amputation,with statistically differences(P<0.05).There were no significant differences in SpO_(2)at T_(2) and T_(3) between group Gg and group Dd(P>0.05).The sleep latency in group G was longer than that in group D,with statistically difference(P<0.05).The awakening time was shorter than that in group D,with statistically difference(P<0.05).The total incidence of adverse events in group G was lower than that in group D,with statistically difference(P<0.05).Conclusion Compared with traditional anesth

关 键 词：发育性髋关节脱位 组合式吸入麻醉诱导装置 七氟醚 氯胺酮 小儿 麻醉诱导 

分 类 号：R614[医药卫生—麻醉学]