不同术前用药对唇腭裂患儿围术期血糖和血浆ACTH的影响  

Influence of different premedication on blood glucose and ACTH in perioperation of cleft and lip 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》2010年第1期53-55,共3页Shaanxi Medical Journal

基　　金：西安交通大学口腔医院青年科研基金资助

摘　　要：目的:通过观察围术期血糖和促肾上腺皮质激素(ACTH)含量的变化,来评价不同术前用药对小儿全麻手术应激反应的影响。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或长托宁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测量血糖及血浆ACTH含量。结果:A组与C组HR、MBP相比较各时点指标均有显著性差异(P<0.05);血糖,与T0比较两组术中各时点均显著增高(P<0.05);ACTH,与T0比较,两组术中各时点均显著增高(P<0.01),且各时点间均有显著性差异(P<0.01)。血糖A组与C组组间各时点相比较,无显著性差异(P>0.05),而ACTHT2、T3有极显著性差异(P<0.01)。结论:长托宁可以降低心血管反应,且在手术期及拔管期发挥了一定的抑制应激反应的作用。Objective：To evaluate the influence of different premedication on stress response of children general anesthesia by observing the lever of glucose and ACTH in perioperation. Methods：Sixty cleft lip and palate 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 premedecated penehyclidine hydrochloride 0.01mg/kg or atropine 0.02 mg/kg 30min before operation. Then they were all intubated in general annethesa. During operation moniter heart rate（HR）,medical blood press（MBP）,artery oxemia saturation（SaO2） and respiration rate （RR）.And peripheral venous blood samples were taken before premedecation （T0）,intubation（T1）,20min after skin incision（T2）,out of intubation （T3）,for determination of blood glucose and plasma ACTH levels. Results：Comparison A group to C group,there were significant difference on HR and MBP at every points（P 0.05）; Glucose,compared with T0,there were at every points in two groups（P 0.05）; ACTH,compared with T0,there were significant difference at every points（P 0.05）,and compared one point with the other,there were great significant difference in two groups （P 0.01）.No significant came out between two groups（P 0.05）.Conclusion：Could inhibit the cardiovascular response but not decrese blood glucose and ACTH level as atropion which stand for the stress response.

关 键 词：唇裂/外科学 腭裂/外科学 阿托品/治疗应用 血糖/代谢 促肾上腺皮质激素/代谢 手术期间 儿童 

分 类 号：R726.2[医药卫生—儿科] R628[医药卫生—临床医学]