纳布啡复合右美托咪定在小儿纤维支气管镜检查中的应用效果观察  

Observation of the Effect of Nalbuphine Compounded with Dexmedetomidine in Pediatric Fiberoptic Bronchoscopy

作　　者：尚平平 刘晓宁 宋直雷 张晗 陈勇 Shang Pingping;Liu Xiaoning;Song Zhilei(Department of Anesthesiology,First Affiliated Hospital of Henan Uni-versity,Kaifeng,Henan,475000,China)

机构地区：[1]河南大学第一附属医院麻醉科,河南开封475000

出　　处：《黑龙江医学》2023年第15期1820-1823,共4页Heilongjiang Medical Journal

基　　金：河南省开封市科技发展计划项目(2003041);河南省开封市科技发展计划项目(1803038)。

摘　　要：目的:探讨纳布啡复合右美托咪定在小儿纤支镜检查中的应用效果,为临床提供参考。方法:回顾性分析2020年3月—2021年6月河南大学第一附属医院收治的接受纤支镜检查的116例患儿的一般资料。根据麻醉方案不同将患儿分为研究组与对照组,每组各58例。对照组采用右美托咪定进行纤支镜检查麻醉;研究组进一步复合纳布啡进行麻醉。对比两组患儿检查不同时间的一氧化氮(Nitric Oxide,NO)、凝血酶原时间(Prothrombin time,PT)、简易精神状态评价量表(Mini-Mental State Examination,MMSE)评分、D-二聚体(D-dimer,D-D)、肾上腺皮质激素(adreno cortico hormones,ACTH)、血小板平均聚集率(aggregation rate of platelet,Ara)。结果:检查后1 d,两组患儿ACTH、NO均升高,但研究组低于对照组,差异有统计学意义(t=3.989、5.319,P<0.05)。检查后1 d、检查后2 d研究组的PT长于对照组,差异有统计学意义(t=2.125、2.917,P<0.05);Ara、D-D低于对照组,差异有统计学意义(t=2.229、2.188、2.199、2.068,P<0.05)。检查前1 d两组患儿各维度评分相比较,差异无统计学意义(t=0.229、0.641、1.351、0.721、0.174,P>0.05)。检查后1 d,两组患儿MMSE各维度评分均降低,差异无统计学意义(t=0.292、1.088、1.514、0.219、0.579,P>0.05)。结论:右美托咪定复合纳布啡在小儿纤维支气管镜检查中的麻醉效果良好确切,患儿检查期间应激水平较低,对患儿凝血功能及认知功能的影响较小。Objective:To investigate the effect of nalbuphine compounded with dexmedetomidine in pediatric fibrinoscopy for clinical reference.Methods:The general data of 116 children admitted to the hospital from March 2020 to June 2021 who under-went fibrinoscopy were retrospectively analyzed,and the children were divided into a study group and a control group according to the different anesthesia protocols,with 58 cases in each group.The control group was anesthetized with dexmedetomidine for fibri-noscopy,and the study group was further compounded with nalbuphine for anesthesia.The nitric oxide(NO),prothrombin time(PT),Mini-Mental State Examination(MMSE)scores,D-dimer(D-D),adreno cortico hormones(ACTH),and average aggregation rate of platelets(Ara)were compared between the two groups at different times of examination.Results:At 1 d after the examina-tion,ACTH and NO were elevated in both groups,but the difference was statistically lower in the study group than in the control group(t=3.989,5.319,P<0.05).PT was longer in the study group than in the control group 1 d after examination and 2 d after examination,with statistically significant differences(t=2.125,2.917,P<0.05),and Ara and D-D were lower than in the control group,with statistically significant differences(t=2.229,2.188,2.199,2.068,P<0.05).There was no statistically significant dif-ference in the scores of each dimension between the two groups 1 d before the examination(t=0.229,0.641,1.351,0.721,0.174,P>0.05).1 d after the examination,the scores of all dimensions of MMSE decreased in both groups of children,and the differences were not statistically significant(t=0.292,1.088,1.514,0.219,0.579,P>0.05).Conclusion:The anesthetic effect of dexmedeto-midine combined with nalbuphine in pediatric fiberoptic bronchoscopy is good and definite,the stress level of the child during the examination is low,and the effect on the coagulation function and cognitive function of the child is low.

关 键 词：纳布啡 右美托咪定 儿童 纤维支气管镜检查 效果 

分 类 号：R614[医药卫生—麻醉学]