60例小儿先天性心脏病介入治疗的麻醉体会(1)
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【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。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
60 cases of children with congenital heart disease interventional therapy Anesthesia
ZHOU Can-hua, XU Peng, MENG Qing-you,et al.
Pingdingshan Coal Mining Bureau Hospital First Medical Group,467000,China
【Abstract】 Objective To compare intravenous anesthesia ketamine and propofol intravenous anesthesia method can be applied to two kinds of narcotic interventional treatment of congenital heart disease in children, to explore its efficacy and safety of anesthesia. Methods 60 cases of selective choice to do interventional therapy in children with congenital heart disease were randomly divided into ketamine group (K) and propofol group (P group), recorded during children body moving, breathing, heart rate, ECG, SpO2 changes and adjust the depth of anesthesia at any time to meet the operation requirements.Results two groups of children with normal circumstances, surgical time and intraoperative SpO2 no significant difference (P>0.05), two groups of children are able to meet the surgical anesthesia, after deoxidization P group was higher than K group (P<0.01).Compared to the two groups, P group of children during quiet, after a smooth, surgery may be better tolerated, and a negligible effect on respiration and circulation, induction and wake up quickly and no obvious side effects and complications. Conclusion Compared to the past traditions of ketamine anesthesia, propofol anesthesia in children with congenital heart disease in the interventional treatment better.
【Key words】 Congenital heart disease; Interventional treatment;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 ......
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