摘要
目的观察帕瑞昔布对小儿腹腔镜手术苏醒期躁动及苏醒期应激反应的影响。方法选择医院2013年1月至12月收治并实施腹腔镜手术的2~5岁患儿122例,按随机数字表法分为观察组和对照组,各61例。观察组在缝合切口时给予帕瑞昔布,对照组给予等量0.9%氯化钠注射液,记录进入手术室平静后(T0),拔管时(T1),拔管后1 min(T2)、5 min(T3)、10 min(T4)时患儿心率(HR)、平均动脉压(MAP)及血氧饱和度(Sp O2)变化情况;记录患儿在苏醒期躁动情况,检测T2时患儿皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)的水平;记录拔管时间及观察并发症发生情况。结果观察组患儿无或轻度躁动评分显著优于对照组,各个时间点的HR及MAP均显著低于对照组(P<0.05),两组患儿Sp O2比较无统计学差异(P>0.05);观察组患儿在T2Cor,E,NE水平均显著低于对照组(P<0.05),拔管时间(6.91±2.11)min,显著短于对照组的(11.32±1.41)min(P<0.05);观察组患儿恶心、呕吐等拔管并发症的发生率为3.28%,显著低于对照组的24.59%(P<0.05)。结论帕瑞昔布能有效减少患儿苏醒期躁动的发生率,有效抑制应激反应,同时不会延长拔管时间且并发症少,值得临床推广。
Objective To explore the influence on parecoxib in agitation and stress response during pediatric laparoscopic surgery.Methods 122 patients aged between 2 to 5 years old from January 2013 to December 2013 treated with laparoscopic surgery were randomly divided into the observation group and the control group,61 cases in each group. Observation group received parecoxib when suturing the incision,control group received saline. The HR,WAP and Sp O2 from the surgery start until extubated 10 min later T0- T4 were observed and recorded. The agitation cases were recorded, and the cortiso, epinephrine, norepinephrine content after extubation( T2) were detected. The extubation time and complications were also recorded. Results Observation group had no or mild agitation rate, and was significantly better than the control group. HR and MAP in observation group were significantly lower than those of the control group at each time point( P < 0. 05), Sp O2 had no significant difference between two groups( P > 0. 05); after extubation, the Cor, E, NE in observation group were significantly lower than those of the control group. Extubation time in observation group was( 6. 91 ± 2. 11) min,which was significantly shorter than control group. Extubation time in observation group was significantly shorter than( 11. 32 ± 1. 41) min of the control group( P < 0. 05). The occurrence rate of complication in the observation group was 3. 28%,which was significantly lower than 24. 59% of the control group( P < 0. 05). Conclusion Parecoxib can effectively reduce the incidence of agitation,effectively inhibit the stress response without prolonging extubation time and has less complication,which is worthy of clinical promotion.
出处
《中国药业》
CAS
2015年第21期83-85,共3页
China Pharmaceuticals
关键词
帕瑞昔布
小儿
腹腔镜手术
躁动
应激反应
parecoxib
pediatric
laparoscopic surgery
agitation
stress response
