目的 觀察依托咪酯乳狀注射液復(fù)合注射用鹽酸瑞芬太尼對(duì)新生兒先天性肛門(mén)閉鎖手術(shù)的麻醉效果。方法 選取2016年3月—2017年3月南陽(yáng)市中心醫(yī)院收治的先天肛門(mén)閉鎖患兒50例為研究對(duì)象，所有患兒以出生時(shí)間進(jìn)行編號(hào)，用電腦隨機(jī)軟件分為對(duì)照組和治療組，每組各25例。對(duì)照組采取咪達(dá)唑侖注射液100 μg/kg聯(lián)合鹽酸氯胺酮注射液2 000 μg/kg進(jìn)行麻醉誘導(dǎo)，術(shù)中鹽酸氯胺酮注射液3～8 mg/（kg·h）靜脈微泵泵注。治療組采取咪達(dá)唑侖注射液100 μg/kg、注射用鹽酸瑞芬太尼1 μg/kg、依托咪酯乳狀注射液2 000 μg/kg進(jìn)行麻醉誘導(dǎo)，術(shù)中依托咪酯乳狀注射液4 mg/（kg·h）、注射用鹽酸瑞芬太尼0.3 μg/（kg·h）微量泵持續(xù)輸注。觀察比較兩組的手術(shù)耗時(shí)、失血量、蘇醒時(shí)間、血氧飽和度（SpO₂）、心率（HR）和平均動(dòng)脈血壓（MAP）。結(jié)果 兩組的手術(shù)耗時(shí)無(wú)明顯差別。治療組手術(shù)中失血量明顯少于對(duì)照組，蘇醒時(shí)間明顯短于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。各時(shí)間段中兩組患兒SpO₂維持在（99±1）%，無(wú)明顯差異。與誘導(dǎo)之前（T1）時(shí)比較，對(duì)照組插管后（T2）和皮膚切開(kāi)時(shí)（T3）的HR、MAP均明顯升高，治療組T3、手術(shù)結(jié)束時(shí)（T4）時(shí)HR、MAP均明顯降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組T2、T3和T4時(shí)的HR、MAP均明顯低于同期對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 依托咪酯乳狀注射液復(fù)合注射用鹽酸瑞芬太尼對(duì)新生兒先天性肛門(mén)閉鎖手術(shù)麻醉具有較好效果，可抑制循環(huán)系統(tǒng)興奮度，降低術(shù)后躁動(dòng)和出血量，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Etomidate Injectable Emulsion combined with Remifentanil Hydrochloride for injection in anesthesia of congenital anal atresia in children. Methods Children (50 cases) with congenital anal atresia in Nanyang City Central Hospital from March 2016 to March 2017 were numbered at birth time and were divided into the control group and the treatment group by computer random software, and each group had 25 cases. Children in the control group were given induction anesthesia by Midazolam Injection 100 μg/kg and Ketamine Hydrochloride Injection 2 000 μg/kg, intravenous micropump infusion of Ketamine Hydrochloride Injection 3-8 mg/(kg·h) during operation. Children in the treatment group were given induction anesthesia by Midazolam Injection 100 μg/kg, Remifentanil Hydrochloride for injection 1 μg/kg and Etomidate Injectable Emulsion 2 000 μg/kg, intravenous micropump infusion of Remifentanil Hydrochloride for injection 0.3 μg/(kg·h) and Etomidate Injectable Emulsion 4 mg/(kg·h) during operation. Surgery time, blood loss, wake time, SpO₂, HR, and MAP in two groups were compared. Results There was no significant difference in the time consuming of the two groups. The blood loss during operation in the treatment group was significantly less than that in the control group, but the wake time in the treatment group was significantly shorter than that in the control group, and there was difference between two groups (P < 0.05). The SpO₂ of children in two groups were (99 ±1)% at every time points, and there was no significant difference. The HR and MAP at T2 and T3 in the control group were significantly higher than those at T1 in the control group, but the HR and MAP at T3 and T4 in the treatment group were significantly lower than those at T1 in the treatment group, and the difference was statistically significant in the same group (P < 0.05). And the HR and MAP at T2, T3 and T4 in the treatment group were significantly lower than those at the same time in the control group, with significant difference between two groups (P < 0.05). Conclusion Etomidate Injectable Emulsion combined with Remifentanil Hydrochloride for injection has good effect in anesthesia of congenital anal atresia in children, can inhibit the excitability of the circulatory system, and reduce postoperative agitation and blood loss, which has a certain clinical application value.