右美托咪定复合丙泊酚麻醉应用于学龄期儿童纤维支气管镜检查的效果评价  

Application of dexmedetomidine combined with propofol anesthesia in fiberoptic bronchoscopy examination for school-age children

作　　者：王静[1] 张磊[1] 董利利[1] 汤昱 Wang Jing;Zhang Lei;Dong Lili;Tang Yu(Department of Respiratory,Children’s Hospital Affiliated to Zhengzhou University,Henan Provincial Children’s Hospital,Zhengdong Branch of Zhengzhou Children’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院郑东院区呼吸科,郑州450000

出　　处：《中国实用医刊》2023年第3期10-13,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关项目(LHGJ20200627)。

摘　　要：目的探讨右美托咪定复合丙泊酚麻醉应用于学龄期儿童纤维支气管镜检查的效果。方法抽取2020年10月至2022年4月郑州大学附属儿童医院收治的拟行纤维支气管镜检查的患儿80例,按照随机数字表法将其分为右美托咪定复合丙泊酚组(DEX组)和丙泊酚组(PRO组)。比较两组苏醒后Ramsay镇静评分,观察并记录两组患儿在检查过程中的呛咳、体动、丙泊酚用量、检查时间及苏醒时间,比较两组检查前后简易精神状态量表(MMSE)评分。结果80例患儿共剔除2例,DEX组和PRO组各纳入39例。DEX组体动和呛咳发生率为2.6%(1/39)、5.1%(2/39),低于PRO组的17.9%(7/39)、20.5%(8/39),P<0.05。两组检查时间比较差异未见统计学意义(P>0.05),DEX组丙泊酚用量少于PRO组(P<0.05),苏醒时间短于PRO组(P<0.05)。苏醒后5、30、60 min,DEX组Ramsay镇静评分均高于PRO组(Z=-6.31、-3.68、-2.93,P均<0.05)。术后1 d,两组MMSE评分低于术前,但DEX组高于PRO组(t=4.32,P<0.05)。结论右美托咪定复合丙泊酚麻醉能有效降低患儿术中呛咳、体动反应,减少术后认知功能障碍、苏醒期躁动,有利于术后恢复,是儿童纤维支气管镜检查术安全的麻醉方式。Objective To investigate the effect of dexmedetomidine combined with propofol anesthesia in fiberoptic bronchoscopy examination for school-age children.Methods A total of 80 children who planned to undergo fiberoptic bronchoscopy examination in Children’s Hospital Affiliated to Zhengzhou University from October 2020 to April 2022 were selected,and they were divided into dexmedetomidine combined with propofol group(DEX group)and propofol group(PRO group)according to the random number table method.Ramsay sedation scores after awakening were compared between the two groups,the coughing,body movement,propofol dosage,examination time and wake-up time during the examination of the two groups were observed and recorded.The Mini-Mental State Examination(MMSE)scores before and after the examination were compared between the two groups.Results Among the 80 children,2 cases were excluded,and 39 cases were included in DEX group and PRO group.The incidences of body movement and coughing in the DEX group were 2.6%(1/39)and 5.1%(2/39),which were lower than 17.9%(7/39)and 20.5%(8/39)in the PRO group(P<0.05).There was no significant difference in the examination time between the two groups(P>0.05).The dosage of propofol in the DEX group was less than that in the PRO group(P<0.05),and the recovery time in the DEX group was shorter than that in the PRO group(P<0.05).At 5,30,and 60 minutes after awakening,the Ramsay sedation scores of the DEX group were higher than those of the PRO group(Z=-6.31,-3.68,-2.93;all P<0.05).One day after operation,the MMSE scores of the two groups were lower than those before operation,but the MMSE score of the DEX group was higher than that of the PRO group(t=4.32,P<0.05).Conclusions Dexmedetomidine combined with propofol anesthesia can effectively reduce coughing and body movement reactions in children during operation,reduce postoperative cognitive function damage,and reduce restlessness during recovery,which is conducive to postoperative recovery.It is a safe anesthesia protocol for fiberoptic bron

关 键 词：右美托咪定 纤维支气管镜 丙泊酚 认知功能 

分 类 号：R726.1[医药卫生—儿科]