【摘要】 目的探讨小儿腹腔镜下疝囊高位结扎术的麻醉处理方法和安全性。方法本组80例腹腔镜下疝囊高位结扎术患儿,ASAⅠ~Ⅱ级,以气管全麻下行术式,入室后连续监测HR、MAP、SpO2、气道峰压(PIP)、PETCO2及体温,并分别记录术前、气腹后5min、气腹后10min、放气后10min的各项监测指标。结果所有患儿麻醉均满意,无一例出现麻醉意外、并发症,CO2气腹后10、20min HR、MAP、PETCO2、PIP显著升高(p<0.05,p<0.01),SpO2无显著变化,放气后10min各项指标与术前相比差异无显著意义。结论面对小儿特殊的解剖、生理和CO2气腹对生理产生的影响,做好术前准备,选择正确的麻醉方法和合适的麻醉药物,维持稳定的循环,小儿可安全实施腹腔镜疝囊高位结扎手术。更多还原

【Abstract】 ObjectiveTo discuss the anesthesia methods and the security of high ligation of hernial sac with laparoscopic operation in infants.Methods 80 infant patients (observed group,ASA Ⅰ～Ⅱ) were operated high ligation of hernial sac with laparoscopic operation,under tracheal general anesthesia.In operation room,the value of HR,MAP,SpO2,PIP,PETCO2 and the temperature is monitored continuously.And the monitor indexes before operation,5 min after CO2 pneumoperitoneum,10 min after CO2 pneumoperitoneum and 10 min after deflation were recorded respectively.Results The anasthesia of all cases were satisfactory,with no accident,no complication.And HR,MAP,PETCO2 and PIP of 10 min after CO2 pneumoperitoneum and 20 min after CO2 pneumoperitoneum rose typically (p<0.05,p<0.01).SpO2 didn’t change obviously.Compared to the indexes before operation,all the indexes had no obvious difference after deflation.Conclusion Due to the special physiology,anatomical structure and the physiological influence of CO2 pneumoperitoneum in infants,if we can prepare well for operation,choose correct anesthesia methods and medicine and maintain stable circulation,a secure high ligation of hernial sac with laparoscopic operation in infants can be obtained.更多还原