摘要
目的观察丙泊酚在儿童可弯曲支气管镜术中的麻醉效果,并对其安全性进行分析。方法回顾性分析2016年1月至2017年1月河北省儿童医院呼吸科行可弯曲支气管镜肺泡灌洗术的206例肺不张患儿的临床资料。患儿为ASAⅠ/Ⅱ级,按照镇静方式分为两组:丙泊酚组(2 mg/kg)106例、咪达唑仑组(0.1 mg/kg)100例。比较两组药物的起效时间,麻醉诱导前后(T0、T1)、置镜时(T2)及清醒后(T3)4个时间点的心率(HR)、呼吸(RR)、平均动脉压(MAP)、经皮血氧饱和度(SPO2),手术持续时间,清醒时间,不良反应发生情况(呃逆、剧烈呛咳、屏气、呕吐),Ramsay镇静评分。采用SPSS 20.0统计软件进行分析。结果 (1)两组在药物起效时间、手术持续时间、术中后不良反应方面差异有统计学意义(P<0.05),在清醒时间上差异无统计学意义(P>0.05);(2)两组患儿在麻醉诱导前后、置镜时、清醒后平均动脉压(MAP)及血氧饱和度(SPO2)差异无统计学意义(P>0.05),但在麻醉诱导后、置镜时及清醒后心率(HR)、呼吸(RR)的差异有统计学意义(P<0.05);(3)两组在Ramsay镇静评分方面差异有统计学意义,丙泊酚组镇静效果优于咪达唑仑组。结论丙泊酚作为深部镇静药物,在儿童可弯曲支气管镜术中具有起效迅速、安全、有效,手术时间短,术后苏醒快,不良反应少等优势,值得推广。
Objective To investigate the efficacy and safety of propofol used as anesthesia and deep sedation during flexible bronchoscopy in children. Methods The clinical data of 206 children with atelectasis who underwent flexible bronchoscopic alveolar lavage in the Endoscopy Room of the Respiratory Department of Hebei Children’s Hospital from January 2016 to January 2017 were retrospectively analyzed. Children for ASAⅠ/Ⅱ level were divided into two groups according to the sedation method :there were 106 cases in the propofol group(2 mg/kg)and 100 cases in the midazolam group(0.1 mg/kg).To compare the onset time of anesthetict,heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),percutaneous oxygen saturation(SPO2)before and after anesthesia induction(T0,T1),during endoscopy placement(T2)and after awakening(T3)at 4 time points,operative duration,the waked duration of postoperation,the rate of adverse reactions(hiccups,respiratory depression)in the operation and Ramsay score between two groups. All data were analyzed by SPSS 20.0 statistical software.Results(1)There were statistically significant differences at the onset time of anestheticts,operative duration and the rate of side-effects between the two groups(P<0.05). There was no statistical differences in awake time(P>0.05).(2)There was no significant difference in MAP or SPO2 at time points of T0,T1,T2,T3(P>0.05),whereas the difference in HR and RR at time points of T1,T2,T3 between the two groups was statistically significant(P<0.05).(3)The sedative effect of propofol group was significantly better than that of midazolam group in Ramsay sedative scoring. Conclusion Propofol used for anesthesia and deep sedation works fast,safely and effectively in flexible bronchoscopy for children;the time to gain consciousness is short,the operation time is short and there is fewer side effects,which is worth promoting.
作者
董伟然
安淑华
李权恒
孙伟
闫智慧
李金英
宫硕康
毕月斋
DONG Wei-ran;AN Shu-hua;LI Quan-heng(No.1Department of Respiration , Heibei Children's Hospital, Shijiazhuang 050031, China)
出处
《中国实用儿科杂志》
CSCD
北大核心
2019年第5期400-404,共5页
Chinese Journal of Practical Pediatrics
基金
河北省医学适用技术跟踪项目(201744)
