目的：探究不同麻醉方法在机器人辅助小儿肾盂成形术中的应用。方法：选取 2019 年 1 月—2023 年 6 月空军军医大学第二附属医院收治的 180 例机器人辅助小儿肾盂成形术患儿，并实施前瞻性研究，按照随机数字表 法分为静脉组（n=90，静脉麻醉）和吸入组（n=90，吸入麻醉）。比较两组患儿心率与平均动脉压、围手术期恢复 与躁动评分指标及不良反应发生情况。结果：与麻醉前相比，两组患者在气管插管即刻、气腹结束时、手术结束时 心率均降低，拔管后升高，平均动脉压在气腹 5 min 和拔管后即刻升高，差异有统计学意义（P<0.05）；与吸入组相比， 静脉组心率变化更显著，静脉组拔管后平均动脉压显著更低，差异有统计学意义（P<0.05）。静脉组围手术期恢复时 间均长于吸入组，差异有统计学意义（P<0.05），但比较两组患者的躁动评分，差异无统计学意义（P>0.05）。与术 前相比，两组患者的部分 C-WISC 评分显著降低，差异有统计学意义（P<0.05）；与吸入组相比，静脉组综合评分更高， 差异有统计学意义（P<0.05）。比较两组不良反应发生率，无显著差异（P>0.05）。结论：相比于吸入麻醉，静脉麻 醉虽苏醒时间较长，但其围手术期血流动力学稳定性更好，且对患儿术后认知功能的影响更小，安全性较好。

Objective: To explore the effect of different types of anesthesia in pediatric robot-assisted pyeloplasty. Methods: A total of 180 children who underwent robot-assisted pyeloplasty in the Second Affiliated Hospital of Air Force Military Medical University from January 2019 to June 2023 were selected and prospectively studied. They were randomly divided into the vein group (n=90, intravenous anesthesia) and the inhalation group (n=90, inhalation anesthesia) using a random number table. The differences in heart rate, mean arterial pressure, perioperative recovery, agitation scores, cognitive function (C-WISC score), and adverse reactoins were compared between the two groups. Results: Compared with that before anesthesia, the heart rates of patients in both groups were decreased at the immediate endotracheal intubation, the end of pneumoperitoneum and operation, and increased after extubation, and the mean arterial pressure increased after 5-min pneumoperitoneum and immediate extubation, with statistical significance (P<0.05). Compared with the inhalation group, the heart rate in the vein group changed more significantly, and the mean arterial pressure after extubation in the vein group was significantly lower, with statistical significance (P<0.05). The perioperative recovery time in the vein group was longer than that in the inhalation group, and the differences were statistically significant (P<0.05), but there was no statistical significance in the agitation score between the two groups (P>0.05). Compared with that before surgery, partial C-WISC scores of the two groups were both significantly decreased, and the difference was statistically significant (P<0.05). Compared with the inhalation group, the comprehensive score of the venin group was higher, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compared with inhalation anesthesia in pediatric robot-assisted pyeloplasty, although has a longer recovery time, intravenous anesthesia could provide better perioperative hemodynamic stability, more safety and less influence on postoperative cognitive function of pediatric patients.

收稿日期：2024-04-15  录用日期：2024-05-15 

Received Date: 2024-04-15  Accepted Date: 2024-05-15 

基金项目：陕西省重点研发计划项目（2021SF-054）

 Foundation Item: Key R&D Project of Shaanxi Province(2021SF-054) 

通讯作者：张进，Email：k-f-c@163.com 

Corresponding Author: ZHANG Jin, Email: k-f-c@163.com 

引用格式：张雅磊，刘晨，李光耀，等 . 不同麻醉方法在机器人辅助小儿肾盂成形术中的应用 [J]. 机器人外科学杂志（中英文）， 2024，5（4）：615-619. 

Citation: ZHANG Y L, LIU C, LI G Y, et al. Effect of different types of anesthesia in pediatric robot-assisted pyeloplasty[J]. Chinese Journal of Robotic Surgery, 2024, 5(4): 615-619.

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