丙泊酚联合纳布啡用于血液病小儿深静脉穿刺的疗效观察

Observation on the efficacy of combination propofol with nabulphine on central venus catheterization in children with hematologic diseases

目的探讨丙泊酚联合纳布啡静脉麻醉在血液病患儿深静脉穿刺置管术中的应用价值。方法选择在手术室行深静脉穿刺置管的血液病患儿60例,随机分为观察组(丙泊酚联合纳布啡)和对照组(单纯丙泊酚),每组各30例。观察组患者使用丙泊酚联合纳布啡麻醉,对照组患者单纯使用丙泊酚麻醉。比较两组患者的丙泊酚用量、穿刺时体动发生率、呼吸抑制发生率、手术时间及清醒时间;记录患儿术后清醒即刻(T1)、术后30 min(T2)、2 h(T3)和6 h(T4)躁动及镇静评分;记录两组患儿术后不良反应的发生情况。结果对照组患者的丙泊酚用量、穿刺时的体动发生率和手术时间均显著高于观察组;两组患者清醒时间和呼吸抑制发生率比较差异无统计学意义;观察组患儿在T1和T2时刻的躁动和镇静评分较对照组更加理想,在T3和T4时刻两组躁动及镇静评分差异均无统计学意义;两组患儿术后不良反应比较差异无统计学意义。结论丙泊酚联合纳布啡静脉麻醉在血液病患儿深静脉穿刺置管术中安全可行,减少术中丙泊酚用量,降低了术后躁动发生率,且不影响患儿清醒时间。

Objective To evaluate the value of propofol combined with nabulphineanesthesia on Methods with hematologic diseases underwent central venus catheterization in the operating room were randomly divided into the observation group(propofol combined with nabophine)and the control group(propofol alone),with 30 patients in each group.Children in the observation group were anesthetized with propofol combined with nalbuphine,while children in the control group were anesthetized with propofol alone.Propofol dosage,the incidence of body movement during puncture,the incidence of respiratory depression,operative time and waking time were compared between the two groups.Restlessness and sedation scores were recorded immediately after wakefulness(T1),30 min(T2),2 h(T3)and 6 h(T4)postoperatively.The occurrence of postoperative adverse reactions in the two groups was recorded.ResultsThe dosage of propofol,the incidence of body movement and the operation time of the patients in the control group were significantly higher than those in the observation group.There were no significant difference in the incidence of respiratory depression and waking time between the two groups.The restlessness and sedation scores of the observation group at T1 and T2 were better than those of the control group,and there was no statistically significant difference between the two groups at T3 and T4.There was no significant difference in postoperative adverse reactions between the two groups.ConclusionPropofol combined with nabulphine intravenous anesthesia is safe and feasible in central venus catheterization of children with hematologic diseases,which reduces the amount of intraoperative propofol,decreasesthe incidence of postoperative agitation,and does not affect the awake time of children.