丙泊酚联合纳布啡用于小儿肝穿刺活检的疗效观察

Observation on the Efficacy of Combination Propofol with Nabulphine on LiverBiopsy in Children

目的:探讨丙泊酚联合纳布啡静脉麻醉在小儿经皮肝穿刺活检中的应用价值.方法:选择在门诊行B超引导经皮肝穿刺活检术的患儿50例,随机分为对照组(单纯丙泊酚)和观察组(丙泊酚联合纳布啡),每组各25例.对照组患儿接受单纯丙泊酚麻醉,观察组患儿实施丙泊酚联合纳布啡麻醉.比较两组患儿的丙泊酚用药量、穿刺时体动发生率、呼吸抑制发生情况、术后清醒时间及术后躁动发生率;记录两组患儿麻醉前(T0)、穿刺前(T1)、穿刺针进入皮肤后(T2)、清醒后(T3)四个时刻的脉搏氧饱和度(SPO2),心率(HR)及平均血压(MBP).结果:观察组患儿的丙泊酚用药量、穿刺时体动发生率及术后躁动发生率均显著低于对照组;呼吸抑制发生率及术后清醒时间两组无明显差异;两组患儿在T1时各指标均显著下降,但观察组患儿各指标均显著高于对照组,T2时两组患儿心率和血压均显著升高,且对照组显著高于观察组.结论:丙泊酚联合纳布啡静脉麻醉在小儿肝穿刺活检术中安全可行,减少了术中丙泊酚用药量,降低术后躁动发生率,且不影响患儿清醒时间.

Objective:To evaluate the value of propofol combined with nabulphineanesthesia in percutaneous liver biopsy in children.Methods:A total of 50 children underwent ultrasound⁃guided percutaneous liver biopsy in the outpa⁃tient department were randomly divided into a control group(propofol alone)and an observation group(propofol com⁃bined with nalbuphine),with 25 cases in each group.Children in the control group were anesthetized with propofol alone,while children in the observation group were anesthetized with propofol combined with nalbuphine.The total dose of propofol,the incidence of body movement during puncture,the incidence of respiratory depression,postoperative waking time and postoperative agitation were compared between the two groups.The pulse oxygen saturation(SPO2),heart rate(HR)and mean blood pressure(MBP)of the two groups were recorded at the following time:before anesthe⁃sia(T0),before puncture(T1),at puncture(T2)and after waking(T3).Results:The dosage of propofol,the inci⁃dence of body movement during puncture and the incidence of postoperative agitation were significantly lower in the ob⁃servation group than in the control group.There were no significant difference in the incidence of respiratory depression and postoperative waking time between the two groups.At T1,all indicators in both groups significantly decreased,but all indicators in the observation group were significantly higher than those in the control group.At T2,heart rate and⁃meanblood pressure in both groups were significantly increased,and the control group was significantly higher than the observation group.Conclusion:Propofol combined with nabulphine intravenous anesthesia is safe and feasible in liver bi⁃opsy of children,which reduces the amount of intraoperative propofol,decreasesthe incidence of postoperative agitation,and does not affect the awake time of children.