目的 观察依托咪酯乳状注射液复合注射用盐酸瑞芬太尼对新生儿先天性肛门闭锁手术的麻醉效果。方法 选取2016年3月—2017年3月南阳市中心医院收治的先天肛门闭锁患儿50例为研究对象，所有患儿以出生时间进行编号，用电脑随机软件分为对照组和治疗组，每组各25例。对照组采取咪达唑仑注射液100 μg/kg联合盐酸氯胺酮注射液2 000 μg/kg进行麻醉诱导，术中盐酸氯胺酮注射液3～8 mg/（kg·h）静脉微泵泵注。治疗组采取咪达唑仑注射液100 μg/kg、注射用盐酸瑞芬太尼1 μg/kg、依托咪酯乳状注射液2 000 μg/kg进行麻醉诱导，术中依托咪酯乳状注射液4 mg/（kg·h）、注射用盐酸瑞芬太尼0.3 μg/（kg·h）微量泵持续输注。观察比较两组的手术耗时、失血量、苏醒时间、血氧饱和度（SpO₂）、心率（HR）和平均动脉血压（MAP）。结果 两组的手术耗时无明显差别。治疗组手术中失血量明显少于对照组，苏醒时间明显短于对照组，两组比较差异具有统计学意义（P<0.05）。各时间段中两组患儿SpO₂维持在（99±1）%，无明显差异。与诱导之前（T1）时比较，对照组插管后（T2）和皮肤切开时（T3）的HR、MAP均明显升高，治疗组T3、手术结束时（T4）时HR、MAP均明显降低，同组比较差异具有统计学意义（P<0.05）；且治疗组T2、T3和T4时的HR、MAP均明显低于同期对照组，两组比较差异具有统计学意义（P<0.05）。结论 依托咪酯乳状注射液复合注射用盐酸瑞芬太尼对新生儿先天性肛门闭锁手术麻醉具有较好效果，可抑制循环系统兴奋度，降低术后躁动和出血量，具有一定的临床推广应用价值。

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.