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目的探讨七氟醚联合氯胺酮对腹腔镜疝高位结扎术患儿血流动力学稳定性、应激状态及术后并发症的影响。方法收集接受腹腔镜疝高位结扎术治疗的患儿80例,按照随机数表法分为对照组和观察组各40例,对照组患儿接受氯胺酮麻醉,观察组患儿接受七氟醚联合氯胺酮麻醉。对比两组患儿围术期血流动力学指标、应激激素水平,术后并发症发生率等差异。结果两组患儿T_1时血流动力学指标、应激激素水平差异无显著性(P>0.05)。观察组患儿T_2、T_4时平均动脉压、心率水平低于对照组患儿,血氧饱和度水平高于对照组患儿;观察组患儿T_2、T_3、T_4时皮质醇、去甲肾上腺素、肾上腺素的含量均低于对照组患儿(P<0.05)。术后观察组患儿躁动、恶心、呕吐、一过性呼吸抑制等并发症发生率低于对照组患儿(P<0.05)。结论七氟醚联合氯胺酮可增加腹腔镜疝高位结扎术患儿的围术期血流动力学稳定性,降低应激水平、减少术后并发症发生。
Objective To investigate the effects of sevoflurane and ketamine on the hemodynamic stability, stress status and postoperative complications in children with high ligation of laparoscopic hernia. Methods Eighty children with high ligation of laparoscopic hernia were collected and divided into control group and observation group according to the random number table method. 40 children in the control group received ketamine anesthesia. The observation group received sevoflurane and ketamine anesthesia. The perioperative hemodynamic parameters, stress hormone levels and the incidence of postoperative complications were compared between the two groups. Results There was no significant difference in hemodynamics and stress hormone levels between two groups at T_1 (P> 0.05). The average arterial pressure and heart rate of T 2 and T 4 in the observation group were lower than those in the control group, and the blood oxygen saturation level in the observation group was higher than that in the control group. In the observation group, the cortisol, norepinephrine , Epinephrine content were lower than the control group children (P <0.05). Postoperative observation group children with agitation, nausea, vomiting, transient respiratory depression and other complication rates were lower than those in the control group (P <0.05). Conclusion Sevoflurane combined with ketamine can increase perioperative hemodynamic stability, reduce the stress level and reduce postoperative complications in children with high ligation of laparoscopic hernia.