摘要
目的观察小儿腹腔镜手术持续应用右美托咪定对患儿围术期应激反应的影响。方法腹腔镜手术患儿40例,随机分为对照组(C组)和右美托咪定组(D组),每组各20例。术中监测HR、MAP、SpO2、PETCO2,并于麻醉前5min(T0)、气腹前5min(T1)、气腹开始后5min(T2)、气腹开始后30min(T3)及气腹结束后30min(T4),测血糖(Glu)、肾上腺素(E)、去甲肾上腺素(NE)及IL-6浓度。结果①苏醒时间D组明显短于C组(P<0.05);术中瑞芬太尼、丙泊酚的用量两组比较差异有统计学意义(P<0.05)。②C组HR、MAP明显高于D组,差异有统计学意义(P<0.05)。③与T0比较两组Glu、E、NE、IL-6均随手术进行逐渐升高,D组T1～T4各时点E、NE、Glu浓度明显降低(P<0.05);与C组比较,D组IL-6水平T2～T4各时点均显著降低(P<0.05)。结论小儿腹腔镜手术可致明显的应激反应,全麻期间持续应用盐酸右美托咪定能有效维持血液动力学的稳定,一定程度上减轻了小儿腹腔镜手术导致的应激。
Objective To investigate the effects of dexmedetomidine on stress response in pediatric patients undergoing laparoscopic operation.Methods Forty patients aged from 2 to 5 years,ASA grade Ⅰ-Ⅱ,undergoing laparoscopic operation were randomly divided into 2 groups：dexmedetomidine group and control group（n=20 in each）.Heart rate（HR）,mean arterial pressure（MAP）,SpO2 and PETCO2 were recorded during operation,so were blood glucose,plasma epinephrine,plasma norepinephrine,and plasma IL-6 recorded five minutes before anesthesia（T0）,5 minutes before pneumoperitoneum（T1）,5 minutes after pneumoperitoneum（T2）,30 minutes after pneumoperitoneum（T3）,30 minutes after operation（T4）.Results（1）HR,MAP of group C were increased obviously at T2,T3,T4 compared with T0（P0.05）,but there was no significant change in group D（P0.05）.Significant difference was found at T1,T2,T3 and T4 between group C and group D.（2） In both groups,the concentration of plasma epinephrine and norepinephrine were increased gradually.Plasma epinephrine and plasma norepinephrine of group C were higher than those of group D（P0.05）.（3）Plasma IL-6 at T2,T3,T4 were higher than that at T1 in both groups（P0.05）,and it showed significant change between two groups at each time point（P0.05）.Conclusion Serious stress response may occur during patients undergoing laparoscopic operation.Continued application of dexmedetomidine can effectively decrease the levels of blood glucose,plasma epinephrine,norepinephrine and IL-6 in pediatric patients undergoing laparoscopic operation,and maintain a more stable hemodynamics,reduces surgical stress response.
出处
《湖北民族学院学报（医学版）》
2012年第1期4-7,共4页
Journal of Hubei Minzu University(Medical Edition)
关键词
右美托咪定
小儿腹腔镜手术
应激
dexmedetomidine
pediatric patients undergoing laparoscopic operation
stress response
