七氟烷与异氟烷全身麻醉用于患儿腹腔镜下疝气手术的比较(1)
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[摘要] 目的 观察七氟烷与异氟烷麻醉用于患儿腹腔镜下疝气手术的效果比较。 方法 选取我院行腹腔镜疝气修补术患儿40例，根据入院顺序随机分为观察组与对照组，每组各20例。观察组采用七氟烷复合麻醉，对照组采用异氟烷复合麻醉。 结果 观察组术前、诱导、切皮、气腹20 min和术毕的心率(HR)和平均动脉压(MAP)变化均较对照组低且平稳(P < 0.05)。观察组自主恢复时间与拔管时间都明显少于对照组(P < 0.05)。 结论 相对于异氟烷，七氟烷用于患儿腹腔镜下疝气手术的全麻，具有血流动力学平稳，自主恢复时间与拔管时间都比较快，副作用小，苏醒迅速和彻底，麻醉深度易于控制，在临床上是一种可行、安全、有效，值得推广的麻醉方式。
[关键词] 七氟烷；异氟烷；患儿；腹腔镜下疝气手术
[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210(2012)02(a)-0081-02
Comparing of Sevoflurane and Isoflurane anesthesia for pediatric laparoscopic hernia surgery
ZHANG Hong
Department of Anesthesiology, Longhua Branch Hospital of the People's Hospital of Shenzhen City, Guangdong Province, Shenzhen 518109, China
[Abstract] Objective To observe the comparing effects of Sevoflurane and Isoflurane anesthesia for pediatric laparoscopic hernia surgery. Methods 40 children with laparoscopic hernia surgery in our hospital were divided into observation group and control group, each group had 20 cases. The observation group was treated with the use of Sevoflurane anesthesia, the control group was treated with the use of Isoflurane anesthesia. Results The changes of preoperative, inducing, skin incision, pneumoperitoneum 20 min and surgery of the HR and MAP in the observation group were lower and more stable than those of control group (P < 0.05). Recovery time and the extubation time of observation group were significantly less than those of the control group (P < 0.05). Conclusion Comparing of Isoflurane, Sevoflurane anesthesia for pediatric laparoscopic hernia surgery has some characters such as less side effects, wake up quickly and thoroughly, easy to control depth of anesthesia, it is a clinically feasible, safe, effective and worthy of anesthesia method.
[Key words] Isoflurane; Sevoflurane; Children; Laparoscopic hernia surgery
当前腹腔镜患儿手术疝气已成为腔镜外科最为成熟的手术方式，具有不剖腹、创伤小、术后恢复快等优点，在临床上已被广泛使用[1]。在麻醉中，其主要采用气管内插管静吸复合全麻替代传统的单纯氯胺酮麻醉[2]，以减少异氟烷麻醉的副作用，虽取得了一定的效果，但围术期呼吸循环管理及术后苏醒仍存在一定顾虑[3]。本文以七氟烷静吸复合用于腹腔镜患儿疝气手术的麻醉，取得了良好的效果，现报道如下：
1 资料与方法
1.1 一般资料
选择2009年5月~2011年5月在我院择期行腹腔镜疝气修补术患儿40例，所有患儿均为美国麻醉医师学会分级(ASA)Ⅰ～Ⅱ级 ......
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