恒速输注右美托咪定和靶控输注瑞芬太尼用于小儿腹股沟疝腹腔镜手术的比较研究  

Comparative study between constant infusion of dexmedetomidine and target-controlled infusion of remifentanil in the laparoscopic operation of children with inguinal hernia

作　　者：刘颖 LIU Ying(Department of Anesthesiology,Qinghai Women and Children Hospital,Xining,Qinghai Province,810001,China)

机构地区：[1]青海省妇女儿童医院麻醉科,青海西宁810001

出　　处：《海南医学院学报》2018年第16期1535-1538,共4页Journal of Hainan Medical University

基　　金：青海省重点攻关项目(2011-N130)~~

摘　　要：目的:探讨恒速输注右美托咪定和靶控输注瑞芬太尼用于小儿腹股沟疝腹腔镜手术的差异。方法:选择2016年9月~2017年12月在本院接受腹腔镜手术治疗的腹股沟疝患儿80例作为研究对象,随机分为右美托咪定组(D组)、瑞芬太尼组(R组),各40例。D组麻醉诱导后恒速静脉泵注右美托咪定,R组麻醉诱导后恒速泵注等容量生理盐水,在手术结束前2min停用丙泊酚及瑞芬太尼。对比两组小儿拔管后即刻(T0)、拔管后5min(T1)、拔管后10min(T2)血流动力学指标水平及血清中炎症因子、神经内分泌指标含量的差异。结果:T0时,两组血流动力学指标水平及血清中炎症因子、神经内分泌指标含量的差异不显著(P>0.05)。T1、T2时,D组血流动力学指标平均动脉压(MAP)、心率(HR)低于R组;血清炎症因子白介素-1β(IL-1β)、白介素-6(IL-6)、C反应蛋白(CRP)含量低于R组;神经内分泌指标皮质醇(Cor)、去甲肾上腺素(NE)、游离甲状腺素(FT4)、血管紧张素Ⅱ(Ang-Ⅱ)含量低于R组(P<0.05)。结论:恒速输注右美托咪定可有效减轻腹股沟疝小儿术后血流动力学波动,抑制机体炎症及应激反应。Objective：To investigate the difference between constant infusion of dexmedetomidine and target-controlled infusion of remifentanil in the laparoscopic operation of children with inguinal hernia.Methods：80 children with inguinal hernia who underwent laparoscopic surgery in the hospital between September 2016 and December 2017 were selected as the research subjects and randomly divided into dexmedetomidine（group D）（n=40）and remifentanil group（group R）（n=40）.Group D received constant intravenous infusion of dexmedetomidine after anesthesia induction,group R received constant infusion of same volume of saline after anesthesia induction,and the propofol and remifentanil were stopped at 2 min before the operation ended.The differences in hemodynamic index levels as well as serum contents of inflammatory factors and neuroendocrine indicators immediately after extubation（T0）,5 min after extubation（T1）and 10 min after extubation（T2）were compared between the two groups of children.Results：At T0,hemodynamic index levels as well as serum contents of inflammatory factors and neuroendocrine indexes were not significantly different between the two groups（P〉0.05）.At T1 and T2,hemodynamic indexes MAP and HR levels of group D were lower than those of group R;serum inflammatory factors IL-1β,IL-6 and CRP contents were lower than those of group R;neuroendocrine indicators Cor,NE,FT4 and Ang-Ⅱ contents were lower than those of group R（P〈0.05）.Conclusion：Constant infusion of dexmedetomidine can effectively relieve the postoperative hemodynamic fluctuation,and inhibit the inflammatory response and stress response in children with inguinal hernia.

关 键 词：腹股沟 右美托咪定 血流动力学 炎症反应 应激反应 

分 类 号：R726.1[医药卫生—儿科]