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目的:比较两种麻醉方式用于小儿腹腔镜手术的效果及其对应激反应、血流动力学的影响。方法:选取宁波大学医学院附属医院2016年11月至2017年11月行腹腔镜手术的患儿100例，采用病床奇偶数分为两组，对照组50例行全身麻醉，观察组50例行瑞芬太尼复合丙泊酚全凭静脉麻醉，比较两组麻醉效果及应激反应、血流动力学指标。结果:观察组术后清醒时间[(31.48±4.19)min]、睫毛反射消失时间[(2.32±1.62)min]、自主呼吸恢复时间[(1.96±1.45)min]、不良反应发生率[4.00%(2/50)]、麻醉中Ramsay评分[(3.69±0.43)分]、麻醉中疼痛评分[(1.96±1.42)分]、术后立即Ramsay评分[(2.11±0.82)分]、术后立即疼痛评分[(2.31±0.43)分]均优于对照组(n t＝15.623、1.436、5.436，χn 2＝5.432，n t＝1.187、1.528、2.136、2.431，均n P<0.05)，观察组各时间段平均动脉压、心率及术后立即的应激反应(皮质醇、血糖、氧分压、平均动脉压)指标均优于对照组(均n P<0.05)。n 结论:全身麻醉在小儿腹腔镜手术中风险较大，可延长意识清醒时间，而瑞芬太尼复合丙泊酚全凭静脉麻醉在小儿腹腔镜手术中，可稳定血流动力学指标，减轻应激反应，提高麻醉安全性。“,”Objective:To compare the effects of two anesthetic schemes on pediatric laparoscopic surgery, and the influence on stress response and hemodynamics.Methods:From November 2016 to November 2017, 100 children underwent laparoscopic surgery in the Affiliated Hospital of Medical College of Ningbo University were selected and divided into two groups by odd even number of beds, with 50 cases in each group.The control group was treated with general anesthesia.The observation group received total intravenous anesthesia with remifentanil and propofol.The anesthesia effect, stress response and hemodynamic indexes were compared between the two groups.Results:The postoperative waking time[(31.48 ±4.19)min], the time of disappearance of mascara reflex[(2.32±1.62)min], the recovery time of spontaneous respiration [(1.96±1.45)min], the incidence of adverse reactions[4.00%(2/50)], Ramsay score[(3.69±0.43)points], VAS score[(1.96±1.42)points], immediate Ramsay score[(2.11±0.82)points] and immediate VAS score[(2.31±0.43)points] in the observation group were better than those in the control group (n t=15.623, 1.436, 5.436, χ n 2=5.432, n t=1.187, 1.528, 2.136, 2.431, all n P<0.05). At different time points, the MAP, HR and stress response(cortisol, blood glucose, PaOn 2, MAP) in the observation group were better than those in the control group(all n P<0.05).n Conclusion:General anesthesia has higher risk in children undergoing laparoscopic surgery and can prolong the time of conscious consciousness.Remifentanil combined with propofol, total intravenous anesthesia can stabilize hemodynamics, improve the safety of anesthesia and alleviate stress reaction in children undergoing laparoscopic surgery.