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目的:观察丙泊酚加瑞芬太尼用于小儿脑病干细胞移植术的麻醉效果。方法:选择行胚胎神经干细胞脑室穿刺移植术80例,随机分为观察组和对照组各40例。对照组给予氯胺酮加咪达唑仑麻醉;观察组给予丙泊酚加瑞芬太尼麻醉。观察比较两组麻醉诱导前(T0)、麻醉诱导后(T1)、注射局麻药(T2)、手术开始(T3)、颅骨钻孔(T4)、神经干细胞移植(T5)、手术结束(T6)和麻醉苏醒(T7)时心率、呼吸频率、血氧饱和度,以及手术时间、麻醉苏醒时间及并发症发生情况等。结果:麻醉诱导前,两组心率、呼吸频率差异不显著(P>0.05);麻醉诱导后,观察组不同时间节点心率、呼吸频率均非常显著低于对照组(P<0.01);观察组心率、呼吸频率均显著低于麻醉诱导前(P<0.05),对照组除T3、T5外,其他各时间节点心率、呼吸频率均显著高于麻醉诱导前(P<0.05)。麻醉诱导后,两组各时间节点血氧饱和度均显著高于诱导前(P<0.05);麻醉诱导后两组间比较,差异不显著(P>0.05)。观察组手术时间、苏醒时间均显著或非常显著短于对照组(P<0.05,P<0.01)。观察组并发症发生率非常显著低于对照组(P<0.01)。结论:丙泊酚加瑞芬太尼用于小儿神经干细胞脑室内穿刺移植术的麻醉效果优于氯胺酮加咪达唑仑麻醉。
Objective: To observe the anesthetic effects of propofol and remifentanil on pediatric encephalopathy stem cell transplantation. Methods: Eighty cases of embryonic neural stem cells were randomly divided into observation group (40 cases) and control group (40 cases). The control group was given ketamine and midazolam anesthesia. The observation group was given propofol and remifentanil anesthesia. (T0), post-anesthesia induction (T1), local anesthetic injection (T2), operation start (T3), skull drilling (T4), neural stem cell transplantation (T5), operation end (T6) And anesthesia recovery (T7) heart rate, respiratory rate, oxygen saturation, and operation time, anesthesia recovery time and complications and so on. Results: Before induction of anesthesia, heart rate and respiratory rate were not significantly different between the two groups (P> 0.05). After the induction of anesthesia, the heart rate and respiratory rate of the observation group were significantly lower than those of the control group at different time points (P <0.01) , Respiration rate were significantly lower than those before induction of anesthesia (P <0.05). The heart rate and respiratory rate at other time points except T3, T5 in control group were significantly higher than those before anesthesia induction (P <0.05). After the induction of anesthesia, the oxygen saturation at each time point in both groups was significantly higher than that before induction (P <0.05). There was no significant difference between the two groups after induction of anesthesia (P> 0.05). The operation time and recovery time in the observation group were significantly or very significantly shorter than those in the control group (P <0.05, P <0.01). The incidence of complications in observation group was significantly lower than that in control group (P <0.01). CONCLUSION: Propofol plus remifentanil is superior to ketamine and midazolam anesthesia in intraventricular perfusion of pediatric neural stem cells.