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【摘要】 目的：研究比較靶控输注丙泊酚及静脉输注瑞芬太尼与静吸复合麻醉在小儿手术麻醉中的麻醉效果及对血流动力学相关指标的影响。方法：选择2014年8月-2016年8月收入的小儿手术患者84例，根据随机数字表法将其分为试验A组和试验B组，每组各42例。试验A组采取全静脉麻醉（靶控输注丙泊酚+静脉输注瑞芬太尼维持麻醉），试验B组采取静吸复合麻醉（吸入七氟醚+静脉输注瑞芬太尼维持麻醉）。观察对比两组患儿的插管时间、意识消失时间、定向力恢复时间、苏醒时间和拔管时间，在麻醉诱导前、术中、术后的各时间点的心率（HR）、动脉压（MAP）及血氧饱和度（SpO2）波动情况，术后并发症发生情况。结果：两组患儿的插管时间、意识消失时间、定向力恢复时间、苏醒时间和拔管时间比较，差异均有统计学意义（P<0.05）；两组患儿术中、术后的HR、MAP比较，差异均有统计学意义（P<0.05）；两组患儿的术后烦躁、恶心呕吐发生率比较，差异均有统计学意义（P<0.05）。结论：静脉输注瑞芬太尼与静吸复合麻醉在小儿手术中的麻醉效果良好，但靶控输注丙泊酚及静脉输注瑞芬太尼的麻醉效果更为理想，对血流动力学指标影响小，术后并发症发生少，值得推广应用。
【关键词】 靶控输注； 丙泊酚； 瑞芬太尼； 七氟醚； 静吸复合麻醉
【Abstract】 Objective：To compare the anesthetic effect of target controlled infusion of propofol，and intravenous infusion remifentanil and combined static and inhalation anesthesia combined intravenous inhalation anesthesia in pediatric surgery anesthesia and its influence on hemodynamic related indexes.Method：84 cases of pediatric surgery from August 2014 to August 2016 were selected，according to the random number table method，they were divided into experimental group A and experimental group B，42 cases in each group.Experimental group A received total intravenous anesthesia（Target controlled infusion of Propofol+intravenous infusion Remifentanil to maintain anesthesia），experimental group B was treated with combined static and inhalation anesthesia（inhaled Sevoflurane+intravenous infusion Remifentanil to maintain anesthesia）.The intubation time，consciousness disappearance time，orientation recovery time，recovery time and extubation time of two groups were observed and compared，the heart rate（HR），arterial pressure（MAP），blood oxygen saturation（SpO2） fluctuation of two groups were compared before anesthesia induction，during and after the operation each time point，and postoperative complications of two groups were compared.Result：The intubation time，consciousness disappearance time，orientation recovery time，recovery time and extubation time of two groups were compared，the differences were statistically significant（P<0.05）.The HR and MAP during operation and after operation of two groups were compared，the differences were statistically significant（P<0.05）.The incidence of postoperative dysphoria，nausea and vomiting of two groups were compared，the differences were statistically significant（P<0.05）.Conclusion：The effect of intravenous infusion Remifentanil and combined static and inhalation anesthesia in pediatric surgery is good，but the anesthesia effect of target controlled infusion of Propofol and intravenous infusion Remifentanil is more ideal，little influence on hemodynamics，reducing postoperative complications，worthy of popularization and application.
【关键词】 靶控输注； 丙泊酚； 瑞芬太尼； 七氟醚； 静吸复合麻醉
【Abstract】 Objective：To compare the anesthetic effect of target controlled infusion of propofol，and intravenous infusion remifentanil and combined static and inhalation anesthesia combined intravenous inhalation anesthesia in pediatric surgery anesthesia and its influence on hemodynamic related indexes.Method：84 cases of pediatric surgery from August 2014 to August 2016 were selected，according to the random number table method，they were divided into experimental group A and experimental group B，42 cases in each group.Experimental group A received total intravenous anesthesia（Target controlled infusion of Propofol+intravenous infusion Remifentanil to maintain anesthesia），experimental group B was treated with combined static and inhalation anesthesia（inhaled Sevoflurane+intravenous infusion Remifentanil to maintain anesthesia）.The intubation time，consciousness disappearance time，orientation recovery time，recovery time and extubation time of two groups were observed and compared，the heart rate（HR），arterial pressure（MAP），blood oxygen saturation（SpO2） fluctuation of two groups were compared before anesthesia induction，during and after the operation each time point，and postoperative complications of two groups were compared.Result：The intubation time，consciousness disappearance time，orientation recovery time，recovery time and extubation time of two groups were compared，the differences were statistically significant（P<0.05）.The HR and MAP during operation and after operation of two groups were compared，the differences were statistically significant（P<0.05）.The incidence of postoperative dysphoria，nausea and vomiting of two groups were compared，the differences were statistically significant（P<0.05）.Conclusion：The effect of intravenous infusion Remifentanil and combined static and inhalation anesthesia in pediatric surgery is good，but the anesthesia effect of target controlled infusion of Propofol and intravenous infusion Remifentanil is more ideal，little influence on hemodynamics，reducing postoperative complications，worthy of popularization and application.