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目的为了保证先天性唇腭裂患儿术中的安全,寻找一种安全可靠的麻醉方法。方法回顾性分析64例年龄为3个月~3岁的先天性唇腭裂患儿的临床资料,对其进行麻醉修补术的麻醉过程及效果进行分析。结果 64例患儿均未出现困难气道,均于静脉诱导下成功气管插管。插管时和手术开始时患儿的心率、血压情况比较,差异均有统计学意义(P<0.05)。因丙泊酚会导致诱导后血压下降,体循环阻力降低,心率下降且心输出量轻微减少。其余时间点患儿的心率及平均动脉压比较差异无统计学意义(P>0.05)。整个过程中血氧饱和度(SPO_2)无变化;手术过程安全平稳。手术结束前3~5 min停药,手术结束后拔管时间为4~9 min,苏醒时间为5~10 min。未见误吸、窒息等危重情况。结论丙泊酚、瑞芬太尼、七氟烷复合麻醉下异形导管气管插管应用于小儿先天性唇腭裂修补术是安全而又有效的方法。
Objective To ensure the safety of surgery in children with congenital cleft lip and palate, to find a safe and reliable method of anesthesia. Methods The clinical data of 64 pediatric patients with congenital cleft lip and palate who were 3 months to 3 years old were analyzed retrospectively. The anesthesia and anesthesia of anesthesia were analyzed. Results None of the 64 children presented with difficult airway and were successfully intubated with intravenous induction. Heart rate and blood pressure at intubation and at the beginning of surgery compared with the difference was statistically significant (P <0.05). Propofol causes a decrease in blood pressure after induction, a decrease in systemic resistance, a decrease in heart rate, and a slight decrease in cardiac output. The remaining time point of children with heart rate and mean arterial pressure was no significant difference (P> 0.05). The whole process of oxygen saturation (SPO_2) no change; safe and stable operation. 3 ~ 5 min before the end of surgery withdrawal, extubation after the end of the surgery for 4 ~ 9 min, recovery time of 5 ~ 10 min. No aspiration, suffocation and other critical conditions. Conclusion Propofol, remifentanil, sevoflurane anesthesia combined with tracheal intubation for congenital cleft lip and palate pediatric repair is a safe and effective method.