不同压力二氧化碳气腹联合艾司氯胺酮预处理应用于小儿腔镜疝气手术中的效果  

Effect of different pressure carbon dioxide pneumoperitoneum combined with esketamine pretreatment for endoscopic hernia surgery of children

作　　者：赵松涛 杜继伟[1] ZHAO Songtao;DU Jiwei(Qingfeng County People's Hospital,Puyang 457300,Henan)

机构地区：[1]清丰县人民医院,河南濮阳457300

出　　处：《菏泽医学专科学校学报》2025年第1期17-20,共4页Journal of Heze Medical College

摘　　要：目的探讨不同压力二氧化碳气腹联合艾司氯胺酮预处理应用于小儿腔镜疝气手术中的效果。方法选择我院收治的腔镜疝气手术患儿80例,按照随机数表法分为对照组和观察组,每组40例。对照组采用10.1~12 mmHg二氧化碳气腹压联合艾司氯胺酮预处理,观察组给予8~10 mmHg二氧化碳气腹压联合艾司氯胺酮预处理。观察两组手术相关指标、脑氧饱和度、呼吸力学指标、麻醉镇静效果。结果两组手术时间、麻醉时间及苏醒时间比较,P>0.05。气腹建立前,两组左、右脑氧饱和度比较,P>0.05;气腹建立后10 min、气腹解除后10 min,观察组左、右脑氧饱和度高于对照组,且观察组变化幅度小于对照组(P<0.05)。气腹建立前,两组PET CO_(2)、气道阻力、气道峰压比较,P>0.05;气腹建立后10 min,两组PET CO_(2)、气道阻力、气道峰压均升高,但观察组上升幅度小于对照组(P<0.05);气腹解除后10 min,两组PET CO_(2)、气道阻力、气道峰压均下降,且观察组低于对照组(P<0.05)。两组Ramsay镇静、Ricker镇静-躁动评分比较,P>0.05。结论在小儿腔镜疝气手术中应用8~10 mmHg二氧化碳气腹压联合艾司氯胺酮预处理,能够有效降低对患儿脑氧饱和度、呼吸系统功能的影响,并且不会影响麻醉镇静效果。Objective To investigate the effect of different pressure carbon dioxide pneumoperitoneum combined with esketamine pretreatment for endoscopic hernia surgery of children.Methods 80 children who received endoscopic hernia surgery in our hospital were selected and divided into the control group and the observation group,40 cases in each group.The control group were pretreated with 10.1~12 mmHg CO_(2)pneumoperitoneum combined with esketamine,the observation group were treated with 8~10 mmHg CO_(2)pneumoperitoneum combined with esketamine.Operation related indexes,cerebral oxygen saturation,respiratory mechanical indexes and anesthetic sedation effects of the two groups were compared.Results There were no significant difference in operation time,anesthesia time and recovery time between the two groups(P>0.05).Before the establishment of pneumoperitoneum,there were no significant difference in left and right cerebral oxygen saturation between the two groups(P>0.05).10 min after pneumoperitoneum established and 10 min after pneumoperitoneum removed,the left and right cerebral oxygen saturation in the observation group was higher than that in the control group,and the change range in the observation group was lower than that in the control group(P<0.05).Before pneumoperitoneum establishment,there were no significant difference in PET CO_(2),airway resistance and airway peak pressure between the two groups(P>0.05).10min after pneumoperitoneum establishment,PET CO_(2),airway resistance and airway peak pressure were increased in both groups,but the increase rate in observation group was less than that in control group(P<0.05).10 min after pneumoperitoneum release,PET CO_(2),airway resistance and airway peak pressure of both groups decreased,and the observation group was lower than the control group(P<0.05).There was no significant difference between Ramsay sedation and Ricker sedation-agitation score between the two groups(P>0.05).Conclusion The application of 8~10 mmHg carbon dioxide pneumoperitoneum pressure combined wit

关 键 词：腔镜疝气手术 艾司氯胺酮 二氧化碳气腹压 脑氧饱和度 呼吸力学指标 

分 类 号：R256.45[医药卫生—中医内科学]