高宝华　王良山　陈展明

【摘要】 目的：比較七氟醚与地氟醚在小儿先天性腭裂修复手术中的麻醉效果。方法：选取2017年8月-2018年3月于本院行腭裂修复手术的患儿80例。按抽信封法随机分为七氟醚组（S组）和地氟醚组（D组），各40例。S组采用七氟醚进行麻醉，D组采用地氟醚进行麻醉。比较两组不同时点的心率、血压，记录苏醒时间、自主呼吸恢复时间、拔管时间，比较两组苏醒期的不良反应。结果：两组各个时点平均动脉压比较差异均无统计学意义（P>0.05）；麻醉诱导时（T0）、气管插管后1 min（T1），两组心率比较均无统计学意义（P>0.05）；手术开始（T2）、手术结束（T3）时，D组心率均高于S组，比较差异有统计学意义（P<0.05）；D组自主呼吸恢复时间、苏醒时间和拔管时间分别为（9.05±2.32）、（10.98±2.30）、（12.12±2.57）min，均短于S组的（13.25±2.11）、（15.18±2.12）、（16.40±2.12）min，比较差异均有统计学意义（P<0.05）；两组术后恶心呕吐、苏醒期躁动、喉支气管痉挛的发生率比较，差异均无统计学意义（P>0.05）。结论：七氟醚与地氟醚均可应用在小儿腭裂修复手术中，但是七氟醚在血流动力学方面效果更稳定，地氟醚在苏醒方面拔管时间更短，临床应合理选择麻醉方法。

【关键词】 七氟醚； 地氟醚； 吸入麻醉； 小儿腭裂修复

Comparison of Anesthetic Effects of Two Different Inhalation Anesthetics for Cleft Palate Repair in Children/GAO Baohua，WANG Liangshan，CHEN Zhanming.//Medical Innovation of China，2018，15（27）：-116

【Abstract】 Objective：To compare the anesthetic effect of Sevoflurane and Desflurane in children with cleft palate repair surgery.Method：A total of 80 children who underwent cleft palate repair in our hospital from August 2017 to March 2018 were selected.According to the envelope method，they were randomly divided into Sevoflurane group （S group） and Desflurane group（D group），40 cases in each group.S group received Sevoflurane anesthesia and D group received Desflurane anesthesia.The heart rate and blood pressure of two groups at different times were compared，the recovery time，spontaneous breathing recovery time and extubation time were recorded，and the adverse reactions during the recovery period between two groups were compared.Result：The mean arterial pressure in two groups at different time points were compared，the differences were not statistically significant（P>0.05）.Anesthesia induction（T0） and after tracheal intubation 1 min（T1），the heart rate in two groups were compared，the differences were not statistically significant（P>0.05）.At the beginning of operation（T2） and at the end of operation（T3），the heart rate of D group were higher than those of S group，the differences were statistically significant（P<0.05）.The spontaneous breathing recovery time，recovery time and extubation time in D group were（9.05±2.32），（10.98±2.30），（12.12±2.57）min，were shorter than（13.25±2.11），（15.18±2.12），（16.40±2.12）min in S group，the differences were statistically significant（P<0.05）.The incidence of postoperative nausea and vomiting，recovery agitation and laryngospasm between two groups were compared，the differences were not statistically significant（P>0.05）.Conclusion：Sevoflurane and Desflurane can be used in the repair of cleft palate in children，but the effect of Sevoflurane in hemodynamics is more stable，Desflurane in the recovery of extubation time is shorter，clinical anesthesia should be reasonable choice.

【Key words】 Sevoflurane； Desflurane； Inhalation anesthesia； Cleft palate repair in children

First-authors address：Xiamen Chang Gung Hospital，Xiamen 361028，China

doi：10.3969/j.issn.1674-4985.2018.27.030

先天性唇腭裂是口腔颌面部最常见的先天性畸形，是国际上最早提出并开始序列治疗的疾病[1]。腭裂患儿在吮吸、进食及语言等生理功能障碍方面比唇裂严重[2]。对于腭裂的患儿，建议9～12个月行外科修补术，这样就能使腭部及早地发挥正常功能[1，3]。患儿可以比较自然地学习说话，建立正常的发音习惯[4]。但是由于腭裂患儿特殊的解剖、手术中有血液、分泌物误入气道的危险，拔管后可发生气道梗阻，对麻醉相对要求较高[5]。近年来新的吸入麻醉药地氟醚和七氟醚麻醉效能可靠，对全身重要脏器影响较小，应用于小儿手术安全性高[6-8]。本研……