韦巧松　卢　冰广西壮族自治区百色市人民医院麻醉科，广西百色　533000

快通道麻醉与常规麻醉对≤6岁患儿先天性心脏病手术的效果及肺部并发症比较

韦巧松卢冰
广西壮族自治区百色市人民医院麻醉科，广西百色533000

目的比较快通道麻醉与常规麻醉对≤6岁患儿先天性心脏病手术的效果及肺部并发症发生率。方法收集我院2015年2月～2016年3月收治的30例行快速麻醉患儿为观察组，抽取同期30例采用常规麻醉患儿为对照组，观察和检测两组拔管30min后血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、pH值、碱剩余（BE）及胸片双肺膨胀、进食时间、住院时间、肺部感染及支气管痉挛等。结果快通道麻醉组气管拔管后30min观察组Pa-CO2、PaO2高于对照组相应值，pH值、BE明显低于对照组，差异均有统计学意义（P＜0.05）；观察组进食时间、住院时间明显短于对照组，差异有统计学有意义（P＜0.05），观察组发生肺部感染和支气管痉挛比例为0，对照组分别为6.7%，16.7%，差异有统计学有意义（P＜0.05）。结论对≤6岁先天性心脏病患儿应用快通道麻醉可显著改善其术后转归质量，值得临床推广。

快通道麻醉；常规麻醉；先天性心脏病；肺部并发症

［Abstract］Objective To compare the effects of congenital heart disease surgery and incidence of pulmonary complications between fast-track anesthesia and regular anesthesia in≤6-year-old patients.M ethods 30 children patientswho were given fast-track anesthesia in our hospital from February 2015 to March 2016 were collected as the observation group，and 30 children patientswho were given regular anesthesia during the same period of time were collected as the controlgroup.PaO2，PaCO2，pH value and BE 30min after extubation were observed and tested in both groups，and bilateral atelectasis by chest radiography，food intake time，length of stay，pulmonary infections and bronchospasm were also observed in both groups.Results 30min after extubation in the fast-track anesthesia group，PaCO2and PaO2in the observation group were higher than those in the controlgroup，and pH and BEwere significantly lower than those in the control group.The differenceswere statistically significant（P＜0.05）；food intake time and length of stay in the observation group were significantly shorter than those in the control group，and the differenceswere statistically significant（P＜0.05）. The proportion ofoccurrence of pulmonary infection and bronchospasm in the observation group was0.0%，and the proportion in the control group was6.7%and 16.7%.The differenceswere statistically significant（P＜0.05）.Conclusion Application of fast-track anesthesia in children patientswith congenital heart disease in≤6-year-old patients is able to significantly improve itspostoperative prognosisquality，which isworthy of clinicalpromotion.

［Key words］Fast-track anesthesia；Regularanesthesia；Congenitalheartdisease；Pulmonary complications

先天性心脏病是临床上常见的先天性疾病，主要是指胚胎发育过程中心脏或者大血管形成障碍及发育异常而导致解剖结构异常，导致胎儿出生时自动关闭的通道未能闭合，其发病率较高，占出生活婴儿的0.4%～1%，在先天畸形中占28%［1］。临床上治疗先天性心脏病主要以根治性手术治疗为主，目前手术过程中麻醉……