儿童喉部激光手术麻醉方式的探讨

Study on the anesthesia method of laryngeal laser surgery in children

目的探讨对儿童患者喉部激光手术的最佳麻醉方式。方法选取2015年6月至2018年6月在舟山医院住院的接受喉部激光手术且<14岁的患儿60例,将2015年6月至2016年12月入院者分为对照组(30例),2017年1月至2018年6月入院者分为干预组(30例)。对照组给予丙泊酚静脉麻醉方式,干预组给予七氟醚吸入麻醉方式。评估两组患者的麻醉临床疗效,两组患者血氧饱和度、血压、心率等情况,两组患者对麻醉工作的满意程度。结果对照组和干预组的临床总有效率分别为80.00%(24/30)、93.33%(28/30),差异有统计学的意义(χ^2=2.298,P<0.05)。干预组患儿的舒张压和收缩压均低于对照组,但血氧饱和度高于对照组,两组比较差异均有统计学意义(t值分别为4.183、4.016、5.943,均P<0.05)。干预组的呼吸恢复时间、手术时间、术后苏醒时间均低于对照组,两组比较差异均有统计学意义(t值分别为4.039、2.208、5.714,均P<0.05)。干预组不良反应发生率低于对照组(χ^2=4.034,P<0.05)。结论对于接受喉部激光手术的患儿而言,手术过程中实行七氟醚吸入麻醉方式能够显著提高患者的麻醉疗效,改善患儿的后续功能恢复,提高患者对于麻醉工作的满意程度,并取得了较好的临床效果。

Objective To explore the best anesthesia method for children receiving laryngeal laser surgery. Methods 60 children less than 14 years old who underwent laryngeal laser surgery in Zhoushan Hospital from June 2015 to June 2018 were selected. Those admitted from June 2015 to December 2016 were selected as the control group(30 cases),and those admitted from January 2017 to June 2018 were divided into the intervention group(30 cases). The control group was given intravenous anesthesia with propofol,and the intervention group was given sevoflurane inhalation anesthesia. The clinical efficacy of anesthesia was evaluated in the two groups,and the oxygen saturation,blood pressure,heart rate and the satisfaction on the anesthesia of the two groups were evaluated and compared. Results The total effective rates of the control group and the intervention group were 24(80.00%) and 28(93.33%),respectively,and the difference was statistically significant(χ^2=2.298,P<0.05). The diastolic and systolic blood pressure in the intervention group were lower than that in the control group,but the blood oxygen saturation was higher than that in the control group,the differences between the two groups were statistically significant(t=4.183,4.016 and 5.943,respectively,all P<0.05). The respiratory recovery time,operation time and postoperative recovery time of the intervention group were all significantly lower than those of the control group(t=4.039,2.208 and 5.714,respectively,all P<0.05). And the incidence of adverse reactions in the intervention group was significantly lower than that in the control(χ^2=4.034,P<0.05). Conclusion For patients undergoing laryngeal laser surgery,the implementation of sevoflurane inhalation anesthesia during the clinical surgical treatment can significantly improve the anesthetic efficacy and the subsequent functional recovery of patients,and improve the satisfaction of the patients with anesthesia,which achieves better clinical results.