摘要
目的探讨丙泊酚联合羟考酮在小儿颅骨凹陷性骨折手术中的麻醉效果。方法选取2019年1月至2021年1月郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院麻醉科收治的90例小儿颅骨凹陷性骨折的患儿,男47例,女43例,年龄(2.18±0.27)岁,年龄范围为1~4岁。根据麻醉药物方案的不同将患儿分为丙泊酚单药组(n=44)和羟考酮联合组(n=46)。丙泊酚单药组患儿接受丙泊酚麻醉维持,羟考酮联合组患儿接受丙泊酚联合羟考酮麻醉维持。比较两组患儿麻醉效果[呼吸恢复时间、开眼时间、拔管时间、术中平均动脉压(MAP)、术中心率]、生化指标[髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)、酸性钙结合蛋白(S-100β)]及术后不良反应发生情况。结果羟考酮联合组患儿呼吸恢复时间[(4.25±0.53)h]、开眼时间[(6.38±1.21)h]、拔管时间[(7.02±1.93)h]均短于丙泊酚单药组[(5.64±0.51)h、(8.94±1.26)h、(9.87±1.98)h],术中MAP[(76.53±1.02)mmHg,1 mmHg=0.133 kPa]、术中心率[(83.61±7.09)次/分]均低于丙泊酚单药组[(81.51±10.17)mmHg、(92.87±7.02)次/分],差异有统计学意义(P<0.05)。治疗后,羟考酮联合组患儿MBP[(14.98±2.87)μg/L]、NSE[(23.18±4.19)μg/L]、S-100β[(1.42±0.33)μg/L]水平均低于丙泊酚单药组[(18.63±2.81)μg/L、(29.87±4.15)μg/L、(1.68±0.32)μg/L],差异有统计学意义(P<0.05)。两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论丙泊酚联合羟考酮用于小儿颅骨凹陷性骨折手术中能提升麻醉效果,促使患儿尽快苏醒,稳定生命体征,减少应激反应。
Objective To investigate the application of propofol combined with oxycodone in the operation of depressed skull fractures in children.Methods A retrospective analysis of the clinical data of 90 children with depressed skull fracture surgery in the department of Anesthesiology,Children′s Hospital of Zhengzhou University,Henan Children′s Hospital,Zhengzhou Children′s Hospital from January 2019 to January 2021 was performed.The clinical data were retrospectively analyzed.There were 47 males and 43 females,aged(2.18±0.27)years old,ranging from 1 to 4 years old.The children were divided into propofol single-drug group(n=44)and oxycodone combination group(n=46)according to the different anesthetic drugs.Children in the propofol monotherapy group received propofol anesthesia maintenance,and the oxycodone combination group received propofol combined with oxycodone anesthesia maintenance.Compare the anesthesia effects of the two groups of children[breathing recovery time,eye opening time,extubation time,intraoperative mean arterial pressure(MAP),intraoperative center rate],biochemical indicators[myelin basic protein(MBP),neuron specific sex enolase(NSE),acid calcium binding protein(S-100β)]and the occurrence of adverse reactions after surgery.Results Breathing recovery time[(4.25±0.53)h],opening time[(6.38±1.21)h],extubation time[(7.02±1.93)h]in oxycodone combination group were shorter than those in propofol single-drug group[(5.64±0.51)h,(8.94±1.26)h,(9.87±1.98)h],intraoperative MAP[(76.53±1.02)mmHg,1 mmHg=0.133 kPa]and intraoperative heart rate[(83.61±7.09)times/min]were significantly lower than those in propofol single-drug group[(81.51±10.17)mmHg,(92.87±7.02)times/min],(P<0.05).After treatment,the levels of MBP[(14.98±2.87)μg/L],NSE[(23.18±4.19)μg/L]and S-100β[(1.42±0.33)μg/L]in the oxycodone combination group were lower than those in the propofol ingle-drug group[(18.63±2.81)μg/L,(29.87±4.15)μg/L,(1.68±0.32)μg/L],the difference was statistically significant(P<0.05).There was no signifi
作者
张玉洁
张磊
齐金莲
何秋娟
李瑜
Zhang Yujie;Zhang Lei;Qi Jinlian;He Qiujuan;Li Yu(Department of Anesthesiology,Children′s Hospital of Zhengzhou University,Henan Children′s Hospital,Zhengzhou Children′s Hospital,Zhengzhou 450000,China)
出处
《中国临床实用医学》
2021年第6期38-41,共4页
China Clinical Practical Medicine
基金
河南省医学科技攻关项目(2018020623)。
关键词
丙泊酚
羟考酮
小儿颅骨骨折
颅骨凹陷性骨折
Propofol
Oxycodone
Skull fracture in children
Skull depression fracture
