钟进财

[摘要] 目的 探討小儿静脉复合麻醉与七氟烷吸入复合静脉麻醉的临床应用效果比照。方法 方便选取2016年1月—2017年10月该院收治的90例小儿手术患儿，随机数字表法分组。对照组用氯胺酮肌肉注射+骶管/硬膜外阻滞，观察组进行七氟烷吸入诱导+骶管/硬膜外阻滞。比较两组小儿手术麻醉效果；体动等并发症发生率；干预前后患儿心率、血氧饱和度水平。术后苏醒时间。结果 观察组小儿手术麻醉效果44例（97.78%）高于对照组32例（71.11%）（χ2=12.180 5，P<0.05）。观察组体动等并发症发生率3例（6.67%）低于对照组11例（24.44%）（χ2=5.413 5，P<0.05）；干预前两组心率、血氧饱和度水平相近（P>0.05）；干预后观察组心率、血氧饱和度水平优于对照组（P<0.05）。观察组术后苏醒时间（18.26±1.21）min短于对照组（36.31±1.12）min（t=8.265，P<0.05）。结论 七氟烷吸入诱导+骶管/硬膜外阻滞在小儿手术麻醉中的效果确切，可更好维持动力学指标稳定和减少并发症发生，提升麻醉效果，缩短术后苏醒时间。

[关键词] 小儿静脉复合麻醉；七氟烷吸入复合静脉麻醉；临床应用效果；比照

[中图分类号] R726.1 [文献标识码] A [文章编号] 1674-0742（2018）10（b）-0100-03

[Abstract] Objective To investigate the clinical application of intravenous anesthesia combined with sevoflurane inhalation. Methods From January 2016 to October 2017， 90 children with pediatric surgery in the hospital were convenient selected and randomly assigned to a digital table. The control group received intramuscular injection of ketamine + fistula / epidural block， and the observation group was induced by sevoflurane inhalation + fistula / epidural block. The anesthesia effect of pediatric surgery was compared between the two groups； the incidence of complications such as body motion； the heart rate and blood oxygen saturation level of the children before and after intervention， postoperative recovery time. Results In the observation group， the anesthesia effect of pediatric surgery was 44 cases（97.78%） higher than that of the control group 32 cases（71.11%）（χ2=12.180 5， P<0.05）. The incidence of complications such as body movement in the observation group was 3 cases（6.67%） lower than that in the control group 11 cases（24.44%）（χ2=5.413 5， P<0.05）. The heart rate and blood oxygen saturation levels of the two groups were similar before the intervention（P>0.05）； The heart rate and blood oxygen saturation level of the group were better than the control group（P<0.05）. The recovery time of the observation group was （18.26±1.21）min， which was shorter than that of the control group （36.31±1.12）min（t=8.265， P<0.05）. Conclusion Sevoflurane inhalation induction + fistula / epidural block is effective in pediatric surgery anesthesia， which can better maintain the stability of kinetic parameters and reduce the incidence of complications， improve the anesthesia effect， and shorten the postoperative recovery time.

[Key words] Pediatric intravenous anesthesia； Sevoflurane inhalation combined intravenous anesthesia； Clinical application effect； Comparison

小儿麻醉和成人麻醉有着一定的区别，需注意患儿的个体特点和身心特点，选择安全、有效的麻醉药物[1-2]。目前小儿静脉复合麻醉与七氟烷吸入复合静脉麻醉是小儿麻醉的常见方法，而其中小儿静脉复合麻醉可引起一定的并发症，为了提高麻醉的安全性，复合七氟烷吸入有一定的帮助。该研究将2016年1月—2017年10月90例小儿手术患儿随机数字表法分组，分析了小儿静脉复合麻醉与七氟烷吸入复合静脉麻醉的临床应用效果比照，报道如下。

1 资料与方法

1.1 一般资料

方便选取该院小儿手术患儿90例，随机数字表法分组。观察组ASAI级20例，II级25例。男25例，女20例；年龄6 个月～7.2岁，体重 7～28 kg。对照组ASAI级21例，II级24例。男24例，女21例；年龄6 个月～7.3 岁，体重 7～27 kg。该研究所选病例经过伦理委员会批准，患者或家属知情同意。

两组一般资料差异无统计学意义（P>0.05）。……