右美托咪定预防交通性鞘膜积液患儿单孔腹腔镜术后躁动的作用及对应激反应指标的影响  

Effect of dexmedetomidine on preventing agitation after single-port laparoscopic surgery in children patients with communicating hydrocele and its influence on stress response indexes

作　　者：李兵才 LI Bingcai(Department of Urological Surgery,Ji'an Municipal Maternal and Child Health Care Hospital,Ji'an,Jiangxi 343000,China)

机构地区：[1]江西省吉安市妇幼保健院泌尿外科,江西吉安343000

出　　处：《检验医学与临床》2023年第19期2889-2892,共4页Laboratory Medicine and Clinic

基　　金：江西省吉安市指导性科技计划项目(吉市科计字[2019]5号102)。

摘　　要：目的探讨右美托咪定预防交通性鞘膜积液患儿单孔腹腔镜术后躁动的作用及对应激反应指标的影响。方法选取2020年3月至2022年3月在该院确诊的接受单孔腹腔镜手术治疗的84例交通性鞘膜积液患儿,随机将患儿分为常规镇定组(42例)和右美托咪定组(42例)。常规镇定组患儿术中采用七氟醚麻醉,右美托咪定组在常规镇定组的基础上加用右美托咪定。记录两组患儿术后的躁动评分、镇静评分(Ramsay评分)、应激反应指标水平和手术麻醉效果。结果重复测量方差分析结果显示,两组患儿的躁动评分和Ramsay评分的时间效应、组间效应和交互效应差异均有统计学意义(P<0.05),术后0 min(T0)时两组患儿的躁动评分差异无统计学意义(P>0.05),术后10 min(T1)、术后20 min(T2)、术后30 min(T3)时右美托咪定组患儿的躁动评分低于常规镇定组患儿,差异均有统计学意义(P<0.05)。T1、T2、T3时右美托咪定组患儿的Ramsay评分高于常规镇定组患儿,差异均有统计学意义(P<0.05)。右美托咪定组患儿的术后Wrench分级情况优于常规镇定组患儿,去甲肾上腺素(NE)、肾上腺素(E)和皮质醇(Cor)水平低于常规镇定组患儿,麻醉维持时间长于常规镇定组患儿,差异均有统计学意义(P<0.05)。右美托咪定组患儿不良反应发生率为9.52%,常规镇定组为14.29%,差异无统计学意义(P>0.05)。结论使用右美托咪定来预防交通性鞘膜积液患儿单孔腹腔镜术后躁动具有较好效果,患儿术后躁动情况明显减轻,应激反应指标水平有所改善,且使用右美托咪定并不影响患儿的麻醉效果。Objective To investigate the effect of dexmedetomidine on preventing agitation and stress response indexes after single-port laparoscopic operation in children patients with communicating hydrocele.Methods Eighty-four children patients which diagnosed communicating hydrocele receiving single-port laparoscopic surgery in this hospital from March 2020 to March 2022 were selected and randomly divided into the conventional sedation group(42 cases)and dexmedetomidine group(42 cases).The conventional sedation group adopted the sevoflurane anesthesia,and the dexmedetomidine group was added with dexmedetomidine on the basis of the conventional sedation group.The agitation score,sedation score(Ramsay score),stress response indexes levels and anesthesia effect were recorded in the two groups.Results The result of repeated measures analysis of variance showed that there were significant differences in the time effect,inter-group effect and interaction effect of agitation score and Ramsay score between the two groups(P<0.05).There was no statistical difference in the agitation scores at postoperative 0 min(T0)between the two groups(P>0.05).The agitation scores at postoperative 10 min(T1),20 min(T2),30 min(T3)in the dexmedetomidine group were lower than those in the conventional sedation group,and the differences were statistically significant(P<0.05).The Ramsay scores at T1,T2 and T3 in the dexmedetomidine group were higher than those in the conventional sedation group,and the differences were statistically significant(P<0.05).The postoperative Wrench grade in the dexmedetomidine group was better than that in the conventional sedation group,the NE,E and Cor levels were lower than those in the conventional sedation group,and the duration of anesthesia maintenance was longer than that in the conventional sedation group,and the differences were statistically significant(P<0.05).The incidence rate of adverse reactions during operation was 9.52%in the dexmedetomidine group and 14.29%in the conventional sedation group,and the diff

关 键 词：交通性鞘膜积液 右美托咪定 单孔腹腔镜手术 术后 躁动 

分 类 号：R614.2[医药卫生—麻醉学]