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1、60例小儿先天性心脏病介入治疗麻醉体会【摘要】目的比较氯胺酮静脉麻醉和丙泊酚静脉麻醉两种麻醉方法用于小儿先心病介入治疗,探讨其麻醉效果和安全性。方法择期选择60例做介入治疗的先心病患儿,随机分成氯胺酮组(K组)和丙泊酚组(P组),记录术中患儿体动,呼吸,心率,ECG,SpO2的变化,并随时调整麻醉深度,满足手术要求。结果两组患儿一般情况,手术时间和术中SpO2无显著性差异(P>0.05),两组患儿麻醉均能满足手术要求,术后清醒时间P组明显快于K组(P<0.01)。两组相比,P组患儿术中安静,经过平稳,可较好的耐受手术,且呼吸循环影响轻微,诱导及苏醒迅速,无明显不良反应及并发症
2、。结论相对于过去传统的氯胺酮麻醉,丙泊酚麻醉在小儿先心病的介入治疗中更理想。�【关键词】先心病;介入治疗;氯胺酮;丙泊酚60casesofchildrenwithcongenitalheartdiseaseinterventionaltherapyAnesthesiaZHOUCan-hua,XUPeng,MENGQing-you,etal.PingdingshanCoalMiningBureauHospitalFirstMedicalGroup,467000,China【Abstract】ObjectiveTocompareintravenousanesthesiaketam
3、ineandpropofolintravenous7anesthesiamethodcanbeappliedtotwokindsofnarcoticinterventionaltreatmentofcongenitalheartdiseaseinchildren,toexploreitsefficacyandsafetyofanesthesia.Methods60casesofselectivechoicetodointerventionaltherapyinchildrenwithcongenitalheartdiseasewererandomlydividedintoke
4、taminegroup(K)andpropofolgroup(Pgroup),recordedduringchildrenbodymoving,breathing,heartrate,ECG,SpO2changesandadjustthedepthofanesthesiaatanytimetomeettheoperationrequirements.Resultstwogroupsofchildrenwithnormalcircumstances,surgicaltimeandintraoperativeSpO2nosignificantdifference(P>0.05),
5、twogroupsofchildrenareabletomeetthesurgicalanesthesia,afterdeoxidizationPgroupwashigherthanKgroup(P<0.01).Comparedtothetwogroups,Pgroupofchildrenduringquiet,afterasmooth,surgerymaybebettertolerated,andanegligibleeffectonrespirationandcirculation,inductionandwakeupquicklyandnoobvioussideeffe
6、ctsandcomplications.ConclusionComparedtothepast7traditionsofketamineanesthesia,propofolanesthesiainchildrenwithcongenitalheartdiseaseintheinterventionaltreatmentbetter.�【Keywords】Congenitalheartdisease;Interventionaltreatment;Ketamine;Propofol临床上常见的先天性心脏病以往多经开胸和体外循环直视下进行修补治疗。近年来,随着封堵装置及材料的不
7、断改进与完善,以及先心病介入治疗技术的迅速发展,经心导管介入封堵术治疗先心病已在临床得到了广泛的应用。2006年3月至2008年11月,我科室配合心内科,在导管室完成各种小儿先心病126例,现随机选取其中30例氯胺酮配合咪唑安定静脉麻醉和30例丙泊酚静脉麻醉,探讨小儿先心病介入治疗的理想麻醉方法。现报道如下。�1资料与方法�1.1一般资料60例择期手术患儿,ASAⅠ~Ⅱ级,动脉导管未闭(PDA)10例,室间隔缺损(VSD)34例,房间隔缺损(ASD)16例,其中男27例,女33例。年龄2~8岁,体质量1