快速康复外科理念麻醉管理在小儿先天性心脏病开胸手术中的作用分析  

Effect of Anesthesia Management Based on Fast Track Surgery Concept in Thoracic Surgery for Congenital Heart Disease in Children

作　　者：刘成森[1] 张小亮[1] 杨小强 LIU Chengsen;ZHANG Xiaoliang;YANG Xiaoqiang(Gaozhou People's Hospital,Anesthesiology Department,Gaozhou,Guangdong 525200)

机构地区：[1]广东省高州市人民医院麻醉科,广东高州525200

出　　处：《智慧健康》2023年第15期264-268,共5页Smart Healthcare

基　　金：茂名市科技计划项目《快速康复麻醉技术在先天性心脏病外科手术中的应用研究》(项目编号:2021004)。

摘　　要：目的 研究在小儿先天性心脏病开胸手术中应用快速康复外科理念麻醉管理的效果。方法 选取本院2020年6月-2022年9月收治的接受开胸手术的先天性心脏病患儿50例,随机分为研究组和对照组,每组各25例,研究组以快速康复外科理念为基础进行麻醉管理,对照组采取常规麻醉管理,比较两组患儿的不良反应、恢复指标、心率、平均动脉压、生活质量(SF-36)评分。结果 研究组的不良反应总发生率显著低于对照组(P<0.05);研究组术后机械通气时间、住院时间显著少于对照组(P<0.05);研究组心内操作时的心率显著低于对照组,诱导后、心内操作时的平均动脉压显著高于对照组(P<0.05);研究组术后SF-36评分显著高于对照组(P<0.05)。结论 在对接受开胸手术的先天性心脏病患儿的麻醉中,采取基于快速康复外科理念的麻醉管理,能够降低手术期间的心率、平均动脉压波动,减少不良反应,改善术后生活质量,促进患儿恢复。Objective To study the effect of rapid rehabilitation surgery concept anesthesia management in children with congenital heart disease thoracotomy.Methods 50 children with congenital heart disease who underwent thoracotomy in our hospital from June 2020 to September 2022 were randomly divided into study group and control group,with 25 cases in each group.The study group was based on the concept of rapid rehabilitation surgery for anesthesia management,while the control group was given routine anesthesia management.The adverse reactions,recovery indexes,heart rate,mean arterial pressure and quality of life(SF-36)scores of the two groups were observed and compared.Results The total incidence of adverse reactions in the study group was significantly lower than that in the control group(P<0.05);the postoperative mechanical ventilation time and hospitalization time in the study group were significantly less than those in the control group(P<0.05).The heart rate during intracardiac operation in the study group was significantly lower than that in the control group,and the mean arterial pressure after induction and intracardiac operation was significantly higher than that in the control group(P<0.05).The postoperative SF-36 score of the study group was significantly higher than that of the control group(P<0.05).Conclusion In the anesthesia of children with congenital heart disease undergoing thoracotomy,anesthesia management based on the concept of rapid rehabilitation surgery can reduce heart rate and mean arterial pressure fluctuations during surgery,reduce adverse reactions,improve postoperative quality of life,and promote recovery of children.

关 键 词：小儿先天性心脏病 麻醉管理 快速康复外科理念 心率 

分 类 号：R726.1[医药卫生—儿科]