右美托咪定对小儿体外循环后炎性因子的影响  

Effect of Dexmedetomidine on Inflammatory Factors in Children after Cardiopulmonary Bypass

作　　者：姜胜奇 韩军[1] 钮建宏[2] JIANG Sheng-qi;HAN Jun;NIU Jian-hong(Department of Anesthesiology,Changzhou Children's Hospital,Nantong University,Changzhou,Jiangsu Province,213000 China;Department of Thoracic Surgery,Changzhou Children's Hospital,Nantong University,Changzhou,Jiangsu Province,213000 China)

机构地区：[1]南通大学附属常州儿童医院麻醉科,江苏常州213000 [2]南通大学附属常州儿童医院胸外科,江苏常州213000

出　　处：《世界复合医学》2019年第12期144-146,共3页World Journal of Complex Medicine

摘　　要：目的阐述患儿手术中体外循环采取右美托咪定麻醉对其围术期炎性因子的作用。方法该次研究时间选定2017年9月-2019年8月,研究对象选定于该院接受体外循环心脏矫治术治疗的患儿60例,参照患儿入院时间先后顺序分为观察组与对照组,观察组患儿在完成麻醉诱导插管、创建静脉通路后泵注右美托咪定,对照组患儿此阶段泵注生理盐水,监测并记录各组患儿分别在实施体外循环前、体外循环结束时、术后6 h、术后24 h相关炎性因子指标差异。结果两组患儿未进行体外循环前,各炎性因子指标差异无统计学意义(P>0.05),实施体外循环后,相应指标均有明显提高,其中观察组患儿体外循环结束时TNF-α(78.94±11.03)、IL-6(60.83±6.34),术后6 hTNF-α(97.99±13.24)、IL-6(91.01±3.29),术后24 h TNF-α(91.57±10.01)、IL-6(87.78±4.11)均明显低于对照组,同时IL-10指标在各时间点均高于对照组(t=21.48、25.85、24.24、9.41、14.29、12.78、8.48、9.87、8.11,P<0.05)。结论患儿接受体外循环手术治疗期间泵注右美托咪定能够明显改善患儿炎性因子指标,确保治疗效果及患儿安全,倡导推广应用。Objective To elucidate the effect of dexmedetomidine anesthesia on perioperative inflammatory factors during cardiopulmonary bypass in children. Methods The study time was selected from September 2017 to August 2019. The study subjects were selected from the hospital for treatment of 60 patients with cardiopulmonary bypass. The patients were divided into observation group and control group according to the order of admission. In the observation group, the patients were injected with dexmedetomidine after completing the anesthesia-induced intubation and creating the venous access. The control group was given saline at this stage, and the children in each group were monitored and recorded before the extracorporeal circulation. There were differences in related inflammatory factors at the end of cardiopulmonary bypass, 6 hours after surgery, and 24 hours after surgery. Results There was no significant difference in the inflammatory factors between the two groups before the cardiopulmonary bypass( P >0.05). After the cardiopulmonary bypass, the corresponding indexes were significantly improved. Among them, at the end of cardiopulmonary bypass in the observation group: the TNF-α(78.94±11.03), IL-6(60.83±6.34), TNF-α(97.99±13.24), IL-6(91.01±3.29) 6 hours after operation, TNF-α(91.57±10.01), 24 hours after operation IL-6(87.78±4.11) were significantly lower than the control group, and the IL-10 index was higher than the control group at each time point(t=21.48, 25.85, 24.24, 9.41, 14.29, 12.78, 8.48, 9.87, 8.11, P<0.05). Conclusion Pumping dexmedetomidine during the treatment of cardiopulmonary bypass can significantly improve the inflammatory factor index in children, ensuring the therapeutic effect and safety of children, and promoting the application.

关 键 词：右美托咪定 小儿 体外循环 炎性因子 影响 

分 类 号：R726[医药卫生—儿科]