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目的:评价不同麻醉方式对胆道闭锁患儿亲体肝移植术后谵妄的影响。方法:择期接受亲体肝移植术胆道闭锁患儿200例，年龄4～12个月，体重4～10 kg，ASA分级Ⅱ或Ⅲ级，Child-Pugh分级B或C级，性别不限。采用随机数字表法分为2组(n n＝100)：静吸复合麻醉组(C组)和全凭静脉麻醉组(T组)。C组静脉输注瑞芬太尼0.1～0.2 μg·kgn -1·minn -1，吸入1%～2%七氟烷；T组静脉输注丙泊酚9～15 mg·kgn -1·hn -1复合瑞芬太尼0.1～0.2 μg·kgn -1·minn -1。2组静脉输注顺苯磺酸阿曲库铵0.12 mg·kgn -1·hn -1。维持BIS值40～60。记录患儿术后气管拔管时间、ICU停留时间和住院时间。于术后1、3和7 d时记录患儿麻醉苏醒期谵妄量表(PAED)评分，以PAED评分>10分作为术后谵妄的评价标准，记录2组谵妄的发生情况。记录术后3月癫痫和颅内感染的发生情况，记录术后1年患儿死亡及再移植的发生情况。n 结果:与C组比较，T组术后1 d时PAED评分降低，术后3 d内谵妄发生率降低(n P0.05)。n 结论:全凭静脉麻醉可降低胆道闭锁患儿亲体肝移植术后谵妄的发生。“,”Objective:To evaluate the effects of different anesthetic methods on delirium after living-related liver transplantation in pediatric patients with biliary atresia.Methods:Two hundred pediatric patients of both sexes with biliary atresia, aged 4-12 months, weighing 4-10 kg, of American Society of Anesthesiology physical status Ⅱor Ⅲ, with Child-Pugh grade B or C, scheduled for elective living-related liver transplantation, were divided into 2 groups (n n=100 each) using a random number table method: combined intravenous-inhalational anesthesia group (C group) and total intravenous anesthesia group (T group). Remifentanil 0.1-0.2 μg·kg n -1·minn -1 was intravenously infused, and 1%-2% sevoflurane was inhaled in C group.Propofol 9-15 mg·kgn -1·hn -1 combined with remifentanil 0.1-0.2 μg·kg n -1·minn -1 were intravenously infused in T group.Cisatracurium besylate 0.12 mg·kgn -1·hn -1 was intravenously infused in both groups.BIS value was maintained at 40-60.The postoperative tracheal extubation time, duration of intensive care unit stay time and length of hospital stay were recorded.The Pediatric Anesthesia Emergence Delirium scale (PAED) score was recorded at 1, 3 and 7 days after operation.PAED score> 10 points was used as the evaluation standard for postoperative delirium, and the occurrence of delirium was recorded in the two groups.The occurrence of epilepsy and intracranial infection was recorded at 3 months after operation.The development of death and retransplantation were recorded at 1 yr after operation.n Results:Compared with C group, PAED score was significantly decreased at 1 day after operation, and the incidence of delirium was decreased within 3 days after operation (n P0.05).n Conclusion:Total intravenous anesthesia can decrease the development of delirium after living-related liver transplantation in pediatric patients with biliary atresia.