长托宁对小儿围术期肾上腺皮质激素含量的影响  

Influence of cortin level in perioperation premedecating penehyclidine hydrochloride for children

作　　者：刘颖[1] 杨壮群[1] 刘西娟[1] 王智[1] 张淼[1] 

机构地区：[1]西安交通大学口腔医院麻醉科,西安710004

出　　处：《陕西医学杂志》2007年第5期596-598,共3页Shaanxi Medical Journal

摘　　要：目的:探讨长托宁与对小儿心血管反应及对肾上腺皮质激素含量的影响。方法:将60例颌面外科3～12岁患儿随机分为两组阿托品组(A组)和长托宁组(C组)。分别于术前30min肌注阿托品0.02mg/kg,长托宁0.01mg/kg。全麻插管,术中常规监测心率(HR),平均动脉压(MBP),呼吸频率(RR),动脉血氧饱和度(SaO2)值。并于术前用药前(T0)、插管时(T1)、手术开始20min(T2)、手术结束拔管时(T3)4个时点采外周静脉血,离心保存于-20℃冰箱,用放射免疫学方法集中测量皮质醇(Cor),血浆醛固酮(ALD)含量。结果:A组与C组HR、MBP相比较各时点指标都有显著增高(P<0.05);A组和C组皮质醇及醛固酮含量都随着时间同步升高,术毕达峰值,A组与C组相比较,两种激素各时点均无显著性差异(P>0.05)。结论:长托宁可以稳定心血管反应,但不能降低小儿围术期肾上腺皮质激素含量。Objective：To compare the influence of penehyclidine hydrochloride with atropine as premedication for children on cardiovascular response and cortin level in perioperation . Methods ：Sixty cleft palate and lip children patients of 3- 12 years old were divided into the penehyclidine hydrochloride group （C group, n = 30） and Atropine group （A group, n ： 30） randomly. They were respectively premedicated with penehyclidine hydrochloride 0. 01mg/kg or atropine 0. 02 mg/kg 30min before operation. Then they were all intubated after anesthesia inducement . During operation heart rate （HR）, medical blood press（MBP）, artery oxemia saturation（SaO2） and respiration rate （RR） were monitored. And 2ml peripheral venous blood samples were taken before premedecation （T0）, intubation （T1）, 20rain after skin incision（T2）, out of intubation （T3）, for determination of plasma Cortisol and aldosterone levels by radioimmunoassay . Results ： Comparied with C group, there was significant difference in HR and MBP at every points in A group（P〈0. 05）; The content of Cortisol and aldosterone in two groups increased with the time and reached the top at the end of the surgry . No significant difference was found between two groups（P〈0.05）. Conclusion： Penehyclidine hydrochloride could inhibit the heart response but not decrese Cortisole level which stand for the stress response.

关 键 词：肾上腺皮质/药理作用 胆碱能拮抗剂/药理学 肾上腺皮质激素类/代谢 手术期间 儿童 

分 类 号：R285.5[医药卫生—中药学]