非插管静吸复合全麻用于小儿腹股沟斜疝腹腔镜手术麻醉的临床观察(1)
摘要：目的 观察研究非插管静吸复合全麻用于小儿腹股沟斜疝腹腔镜手术麻醉的临床效果。方法 根据随机数字表法选取2014年10月～2016年10月在我院行腹股沟斜疝腹腔镜手术的患儿100例，随机分为对照组和观察组各50例。其中对照组患儿采用插管全麻的方式进行麻醉，观察组患儿采用静脉复合七氟醚吸入的方式进行麻醉，比较两组患儿术后的手术时间和苏醒时间以及建立气腹前5 min、后5 min和15 min及放气后5 min的心率(HR)、动脉压(MAP)和血氧饱和度(SpO2)变化情况。结果 两组患儿的手术时间以及HR、MAP和SpO2变化无显著性差异；观察组患儿的苏醒时间优于对照组患者的苏醒时间；两组患儿建立气腹后的HR和MAP均较建立前的HR和MAP显著提高。结论 非插管静吸复合全麻用于小儿腹股沟斜疝腹腔镜手术的麻醉中，能够取得极为满意的效果。
关键词：静吸复合全麻；非插管；腹腔镜手术
Clinical Observation of Laparoscopic Surgery for Anesthesia of Inguinal Hernia in Children with Non-intubation Combined with General Anesthesia
, http://www.100md.com
LAN Bin
(Department of Anesthesiology，Fushun County People's Hospital，Zigong 643200，Sichuan，China)
Abstract：Objective To study the effects of non intubation general anesthesia for clinical anesthesia pediatric inguinal hernia laparoscopic surgery. Methods According to the random number table method from October 2014～2016 year in October in our hospital underwent laparoscopic inguinal hernia surgery in children with 100 cases，were randomly divided into control group and observation group with 50 cases in each group.The control group were treated with general anesthesia intubation the way of anesthesia，the observation group was treated by the way of combined intravenous and inhalation anesthesia，the operation time and recovery time of the two groups were compared，and the changes of heart rate(HR)，arterial pressure(MAP) and oxygen saturation(SpO2)were measured before and after the establishment of 5 min，and after the first 5 min and 15 min，and the rate of 5 min after discharge.Results There was no significant difference in the operation time and HR，MAP and SpO2 between the two groups.The recovery time of the observation group was better than that of the control group.The HR and MAP of the two groups were higher than those of the control group before the establishment of HR and MAP significantly improved.Conclusion Non-intubation combined with general anesthesia for anesthesia in pediatric inguinal hernia laparoscopic surgery can achieve very satisfactory results.
, 百拇医药
Key words：Combined with general anesthesia；Non-intubation；Laparoscopic surgery
腹腔镜技术由于具有痛苦小、创伤小、术后恢复快、住院时间短等特点，已经成为一种最常应用的微创技术，并在小儿外科手术中广泛应用。临床中，传统的气管插管麻醉方法应用最为广泛，但对于小儿患者，在插管及拔管的过程中，均会非常容易對患儿造成损伤，并加重应激反应，加上麻醉期患儿的会有较为剧烈快速的体征变化，易产生较大的麻醉风险。多项研究均表明，复合麻醉能够有效地降低麻醉药物的使用量，且并发症少而被越来越多的受到关注[1-2]。因此，在本次研究中，采用非插管静吸复合全麻的方法应用于小儿腹股沟斜疝腹腔镜手术中，探究其麻醉效果与安全可靠性，现报道如下。
1 资料与方法
1.1一般资料 根据随机数字表法选取2014年10月～2016年10月在我院行腹股沟斜疝腹腔镜手术的患儿100例，术前检查排除心、肺疾病，无呼吸系统感染及神经系统疾病，并根据麻醉用药情况分为对照组(全麻插管组)和观察组(非插管静吸复合全麻组)，各50例。对照组中男41例，女9例，年龄2～12岁，平均年龄(5.3±2.7)岁；观察组中男45例，女5例，年龄2～11岁，平均年龄(5.1±2.3)岁。患儿入选标准：①符合相关诊断标准并确诊为腹股沟斜疝；②心、肝、肾功能等脏器正常并符合腹腔镜手术指征；③无麻醉禁忌证并符合美国麻醉协会(ASA)评分Ⅰ级；④家属知晓本次研究目的，并签署知情同意书。两组患儿在性别构成比、年龄、体质量、病情程度以及手术时间等一般性临床资料方面无显著性差异，无统计学意义(P>0.05)，具有可比性。, 百拇医药(兰彬)
关键词：静吸复合全麻；非插管；腹腔镜手术
Clinical Observation of Laparoscopic Surgery for Anesthesia of Inguinal Hernia in Children with Non-intubation Combined with General Anesthesia
, http://www.100md.com
LAN Bin
(Department of Anesthesiology，Fushun County People's Hospital，Zigong 643200，Sichuan，China)
Abstract：Objective To study the effects of non intubation general anesthesia for clinical anesthesia pediatric inguinal hernia laparoscopic surgery. Methods According to the random number table method from October 2014～2016 year in October in our hospital underwent laparoscopic inguinal hernia surgery in children with 100 cases，were randomly divided into control group and observation group with 50 cases in each group.The control group were treated with general anesthesia intubation the way of anesthesia，the observation group was treated by the way of combined intravenous and inhalation anesthesia，the operation time and recovery time of the two groups were compared，and the changes of heart rate(HR)，arterial pressure(MAP) and oxygen saturation(SpO2)were measured before and after the establishment of 5 min，and after the first 5 min and 15 min，and the rate of 5 min after discharge.Results There was no significant difference in the operation time and HR，MAP and SpO2 between the two groups.The recovery time of the observation group was better than that of the control group.The HR and MAP of the two groups were higher than those of the control group before the establishment of HR and MAP significantly improved.Conclusion Non-intubation combined with general anesthesia for anesthesia in pediatric inguinal hernia laparoscopic surgery can achieve very satisfactory results.
, 百拇医药
Key words：Combined with general anesthesia；Non-intubation；Laparoscopic surgery
腹腔镜技术由于具有痛苦小、创伤小、术后恢复快、住院时间短等特点，已经成为一种最常应用的微创技术，并在小儿外科手术中广泛应用。临床中，传统的气管插管麻醉方法应用最为广泛，但对于小儿患者，在插管及拔管的过程中，均会非常容易對患儿造成损伤，并加重应激反应，加上麻醉期患儿的会有较为剧烈快速的体征变化，易产生较大的麻醉风险。多项研究均表明，复合麻醉能够有效地降低麻醉药物的使用量，且并发症少而被越来越多的受到关注[1-2]。因此，在本次研究中，采用非插管静吸复合全麻的方法应用于小儿腹股沟斜疝腹腔镜手术中，探究其麻醉效果与安全可靠性，现报道如下。
1 资料与方法
1.1一般资料 根据随机数字表法选取2014年10月～2016年10月在我院行腹股沟斜疝腹腔镜手术的患儿100例，术前检查排除心、肺疾病，无呼吸系统感染及神经系统疾病，并根据麻醉用药情况分为对照组(全麻插管组)和观察组(非插管静吸复合全麻组)，各50例。对照组中男41例，女9例，年龄2～12岁，平均年龄(5.3±2.7)岁；观察组中男45例，女5例，年龄2～11岁，平均年龄(5.1±2.3)岁。患儿入选标准：①符合相关诊断标准并确诊为腹股沟斜疝；②心、肝、肾功能等脏器正常并符合腹腔镜手术指征；③无麻醉禁忌证并符合美国麻醉协会(ASA)评分Ⅰ级；④家属知晓本次研究目的，并签署知情同意书。两组患儿在性别构成比、年龄、体质量、病情程度以及手术时间等一般性临床资料方面无显著性差异，无统计学意义(P>0.05)，具有可比性。, 百拇医药(兰彬)
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