| 罗 亮,刘少星,朱 波,蒋蓉娟,谢先丰.低体质量小儿心脏手术中应用七氟醚全身麻醉诱导的效果及其对血流动力学的影响[J].,2019,19(4):763-766 |
| 低体质量小儿心脏手术中应用七氟醚全身麻醉诱导的效果及其对血流动力学的影响 |
| Effect of Sevoflurane General Anesthesia Induction on Cardiac Surgery of Low Body Mass Children and its Influence of Hemodynamics |
| 投稿时间：2018-05-24 修订日期：2018-06-18 |
| DOI：10.13241/j.cnki.pmb.2019.04.035 |
| 中文关键词: 低体质量 心脏手术 患儿 七氟醚 氯胺酮 血流动力学 |
| 英文关键词: Low body mass Cardiac surgery Children Sevoflurane Ketamine Hemodynamics |
| 基金项目:四川省医学会科研基金项目（S16004） |
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| 中文摘要: |
| 摘要 目的：探讨低体质量小儿心脏手术中应用七氟醚全身麻醉诱导的效果及其对血流动力学的影响。方法：选择本院2016年7月-2018年2月期间收治的28例低体质量小儿心脏手术患儿纳入本研究，按照随机数字表法将患儿分为对照组和观察组各14例。对照组采用氯胺酮进行全身麻醉诱导，观察组采用七氟醚吸入麻醉进行全身麻醉诱导。观察两组患儿麻醉诱导敏感性及不良反应等情况，比较两组患儿诱导前、诱导过程中、插管即刻的收缩压（SBP）、舒张压（DBP）、心率（HR）及血氧饱和度（SaO2）水平。结果：观察组患儿哭闹时间、睫毛反射消失时间及疼痛反射消失时间显著低于对照组（P<0.05）。观察组患儿不良反应发生率为7.14%（1/14），与对照组的28.57%（4/14）比较差异无统计学意义（P>0.05）。诱导过程中及插管即刻，对照组患儿SBP、DBP均低于诱导前和观察组，HR高于诱导前和观察组，SaO2先降低后升高，且低于观察组（P<0.05），观察组患儿SBP低于诱导前，SaO2高于诱导前（P<0.05），而DBP、HR与诱导前比较无统计学差异（P>0.05）。结论：与氯胺酮相比，采用七氟醚吸入全身诱导麻醉，其对低体质量小儿心脏手术患儿的循环干扰较小，同时在诱导过程中安全稳定，对血流动力学影响较小，容易被患儿所接受。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of sevoflurane general anesthesia induction on cardiac surgery of low body mass children and its influence of hemodynamics. Methods: 28 children with low body mass undergoing cardiac surgery in our hospital from July 2016 to February 2018 were included in this study. According to the random number table method, the children were divided into the control group and the observation group, 14 cases in each group. The control group was induced by Ketamine for general anesthesia, and the observation group was given sevoflurane inhalation anesthesia for induction of general anesthesia. The sensitivity and adverse reactions of the two groups were observed. The levels of systolic pressure(SBP), diastolic pressure(DBP), heart rate(HR), oxygen saturation(SaO2) before induction, induction process, intubation immediately of the two groups were compared. Results: The crying time, eyelash reflex disappearing time and the pain reflex disappearing time in observation group significantly were lower than that in the control group (P<0.05). The incidence rate of adverse reactions in the observation group was 7.14%(1/14), there is no statistical difference compared with the 28.57% (4/14) in the control group (P>0.05). In the induction process and intubation immediately, the SBP and DBP in the control group were lower than before induction and the observation group, the HR was higher than before induction and the observation group, the SaO2 decreased first and then increased, and was lower than that in the observation group(P<0.05). The SBP in the observation group was lower than before induction, and the SaO22 was higher than before induction(P<0.05), but there was no statistical difference of DBP and HR compared with before induction(P>0.05). Conclusion: Compared with Ketamine, using sevoflurane inhalation of general induc- tion anesthesia has less disturbance to the cardiac surgery children with low body mass, and it is safe and stable in the induction process,and has less influence on the hemodynamics, which is easy to be accepted by children. |
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