试论小儿麻醉临床分析研究.docxVIP

试论小儿麻醉临床分析研究 【内容摘要】 目的 讨论氯胺酮复合丙泊酚用于小儿手术麻醉的临床效果。方法 将2009年1月到2010年2月于我院进行手术的80例患儿随机分为两组，氯胺酮组37例使用氯胺酮单独麻醉，联合组43例采取氯胺酮联合丙泊酚的麻醉方法，观察两组术后的不良反应发生率和术后清醒时间，进行统计分析。结果 联合组术前和术后hr和rr变化优于氯胺酮组，两组比较差别有统计学意义，p 0.05；联合组的不良反应发生率为9.3%低于氯胺酮组的24.3%，两组比较差别有统计学意义，p 0.05；联合组的患儿清醒时间短于氯胺酮组，两组比较差别也具有统计学意义，p 0.05。结论 氯胺酮复合丙泊酚用于小儿手术麻醉的效果优于单一的氯胺酮麻醉，值得推广应用。 【本文关键词语】 氯胺酮；丙泊酚；小儿麻醉；研究 clinical analysis of pediatric anesthesia 【abstract】 objective to investigate the ketamine and propofol anesthesia for pediatric clinical effect. methods from january 2009 to february 2010 in our hospital 80 cases surgery children were randomly divided into two groups of 37 cases of ketamine anesthesia using ketamine alone, 43 cases combined with propofol ketamine anesthesia to observe the postoperative incidence of adverse reactions, and postoperative recovery time, for statistical analysis. results the preoperative and postoperative changes in hr and rr were better than the ketamine group, the difference was statistically significant, p 0.05; 9.3% adverse reaction rate in combined group was 24.3% lower than the ketamine group,there were significant differences between groups, p 0.05;recovery time in children of combimed group were less than ketamine group, the difference was also statistically significant, p 0.05. conclusion ketamine and propofol anesthesia for children is better than a single ketamine anesthesia, should be widely applied. 【key words】 ketamine; propofol; pediatric anesthesia; research  氯胺酮用于小儿手术麻醉具有支气管扩张作用，临床剂量仅有稍微的呼吸抑制，具有兴奋交感神经，增长外周血管阻力，使心率增快、血压升高，加重术中的应激反应作用，术后恶心、呕吐、躁动等不良反应发生率高［1］。我院使用氯胺酮复合丙泊酚用于小儿术前麻醉，获得了良好的效果，现报告如下。 1 资料与方法 1.1 一般资料 我院2009年1月到2010年2月收治住院需手术患儿80例，男50例，女30例，年龄1~12岁，平均(6.5±3.2)岁，其中急慢性阑尾炎手术46例(氯胺酮组21例，联合组25例)，会阴部手术21例〔氯胺酮组9例，联合组12例〕，骨科手术13例〔氯胺酮组7例，联合组6例〕，随机分为氯胺酮组37例和氯胺酮复合丙泊酚组43例。两组性别、年龄和手术类型差别均无统计学意义，p 0.05，具有可比性。 1.2 麻醉方法 手术前一天询问病史、体格检查及实验室检查。手术前禁食6~8 h、禁饮4~6 h。两组术前30 min肌注阿托品0.01~0.02 mg/kg，苯巴比妥钠2 mg/kg。氯胺酮组：开放静脉通道，给予氯胺酮2 mg/kg连续缓慢静脉滴注，术中保留自立呼吸，坚持呼吸