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目的探讨腹腔镜婴幼儿先天性胆总管囊肿手术的麻醉管理经验。方法回顾性分析50例先天性胆总管囊肿手术的麻醉资料。结果骶管阻滞+全麻气管插管22例(Ⅰ组);静脉复合全麻气管插管28例(Ⅱ组)。全部患儿麻醉效果满意。两组并发症比较差异无统计学意义(P>0.05),术后患儿苏醒时间Ⅰ组明显延迟(P<0.05)。结论两种麻醉方法用于腹腔镜婴幼儿先天性胆总管囊肿手术是可行的,但由于该类手术时间长,CO2气腹对婴幼儿肺通气、血流动力学及体温变化产生一定的影响,宜加强术中管理,预防并发症的发生。
Objective To explore the anesthesia management experience of laparoscopic congenital choledochal cyst surgery. Methods A retrospective analysis of 50 cases of congenital choledochal cyst surgery anesthesia data. Results Sacral block + anesthesia intubation in 22 cases (group Ⅰ); intravenous anesthesia intubation in 28 cases (group Ⅱ). All children satisfied with the anesthesia. There was no significant difference in complication between the two groups (P> 0.05), and the recovery time in group I was significantly delayed (P <0.05). Conclusions The two anesthesia methods are feasible for laparoscopic operation of congenital choledochal cyst in infants and young children. However, due to the long duration of such surgery, CO2 pneumoperitoneum has some effects on pulmonary ventilation, hemodynamics and body temperature in infants and young children. Should strengthen intraoperative management, prevention of complications.