脑瘫因素对患儿术后疼痛敏感性的影响  

Effect of cerebral palsy factor on sensitivity of postoperative pain in pediatric patients

作　　者：赵泽宇 张蓉 程庆 刘建波 王馨雪 黄建盛 

机构地区：[1]四川省八一康复中心麻醉科,成都市611135

出　　处：《中华麻醉学杂志》2015年第12期1480-1482,共3页Chinese Journal of Anesthesiology

基　　金：四川省卫生厅科研课题（130250）

摘　　要：目的评价脑瘫因素对患儿术后疼痛敏感性的影响。方法择期行下腹部及下肢手术脑瘫患儿25例，为脑瘫组（P组），另取非脑瘫患儿25例为对照组（C组），ASA分级Ⅰ或Ⅱ级，年龄3～7岁，体重11～25kg，性别不限。术后2h时采用行为学评分法：哭泣、呼吸、循环、表情、睡眠评分法（CRIES评分法）评价疼痛程度。于术前、术后2h、24h时采集外周静脉血样，采用放射免疫法测定血浆β-内啡肽浓度，采用高效液相色谱法测定血浆儿茶酚胺（以肾上腺素计）浓度。结果与术前比较，2组患儿术后血浆β-内啡肽浓度降低，血浆儿茶酚胺浓度升高（P〈0．01）。与C组比较，P组术后CRIES评分升高，术前和术后血浆β-内啡肽浓度降低，术后血浆儿茶酚胺浓度升高（P〈O．05或0．01）。结论脑瘫患儿术后疼痛敏感性升高。Objective To evaluate the effect of cerebral palsy factor on the sensitivity of postopera- tive pain in the pediatric patients. Methods Twenty-five pediatric patients with cerebral palsy of both se- xes, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , aged 3-7 yr, weighing 11-25 kg, scheduled for elective lower abdominal or lower extremity surgery, served as cerebral palsy group （ group P）. Another 25 pediatric patients without cerebral palsy of both sexes, of American Society of Anesthesiol- ogists physical statusⅠ or Ⅱ , aged 3-7 yr, weighing 11-25 kg, served as control group （group C）. At 2 h after surgery, pain was evaluated by using CRIES （crying, requires O2 saturation, increased vital sign, expression and sleeplessness）. Peripheral venous blood samples were collected before surgery, and at 2 and 24 h after surgery, and the concentrations of plasma β-endorphin were measured by radio-immunity method, and the concentration of plasma cateeholamine （adrenaline） was determined by high performance liquid chromatography. Results Compared with the value before surgery, the plasma concentrations of β- endorphin were significantly decreased, and the concentrations of plasma eatecholamine were increased after surgery in the two groups （P 〈 0.01）. Compared with group C, the CRIES score was significantly in- creased after surgery, the concentration of plasma β-endorphin was decreased before and after surgery, and the concentration of plasma catecholamine was increased after surgery in group P （ P〈 0.05 or 0.01 ）. Con- clusion The sensitivity of postoperative pain is increased in the pediatric patients with cerebral palsy.

关 键 词：疼痛 手术后 脑性瘫痪 儿童 

分 类 号：R726.1[医药卫生—儿科]