不同全麻维持药物对婴幼儿唇腭裂手术后短期神经行为学发育的影响  

The effect of maintenance anesthetics on neurobehavioral development of infants undergoing cleft lip and palate surgery

作　　者：刘文辉[1] 周循 马莉 李静洁 刘锦星[1] 仇琳[1] LIU Wen-hui;ZHOU Xun;MA Li;LI Jing-jie;LIU Jin-xing;QIU Lin(Department of Anesthesiology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科,上海200011

出　　处：《中国口腔颌面外科杂志》2025年第2期145-151,共7页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:研究不同全身麻醉维持药物对婴幼儿唇腭裂手术后短期神经行为发育的影响。方法:纳入2岁以下在全身麻醉下行唇腭裂手术的患儿79例,按照麻醉维持期间用药方式不同分为吸入麻醉组(IA组)和静吸复合麻醉组(CIIA组)。记录术前基线(T0)、术后6个月(M6)及术后12个月(M12)时的盖泽尔发育诊断量表(Gesell Development Diagnosis Scale,GDDS)评分,结果包括适应性、精细运动、粗运动、语言和社交技能5个能区,比较组间GDDS各能区评分在术后各随访点的差异,并进行矫正回归分析。采用R 4.0.5软件包对数据进行统计学处理。结果:术前两组患儿基本特征及基线GDDS评分各能区组间无统计学差异,麻醉诱导用药及全麻维持的吸入用七氟烷浓度两组之间也无统计学差异。在矫正月龄、身体质量指数、性别、母亲教育程度、家庭收入、麻醉时间等影响因素后,M12时间点CIIA组精细动作能力显著低于IA组(P<0.05)。结论:在全身麻醉维持阶段,相比全凭吸入麻醉,在此基础上复合静脉麻醉对唇腭裂患儿全麻术后短期的精细动作能力可能造成轻度影响。PURPOSE:To study the effect of different maintenance anesthetics on postoperative short-term neurobehavioral development in children undergoing cleft lip and palate surgery.METHODS:A total of 79 children under 2 years old who underwent cleft lip and palate surgery under general anesthesia were divided into inhalation anesthesia group(group IA)and combined intravenous inhalation anesthesia group(group CIIA)according to different medication methods during anesthesia maintenance.The Gesell Development Diagnosis Scale(GDDS)scores were recorded at preoperative baseline(T0),6 months after surgery(M6)and 12 months after surgery(M12).The results included 5 functional areas of adaptability,fine motor,gross motor,language and social skills.The difference of GDDS scores between groups at each follow-up point was compared,and corrected regression analysis was performed.R 4.0.5 software was used for data analysis.RESULTS:There was no significant difference in basic characteristics and baseline GDDS scores between the two groups of patients before surgery,the induced medication and the sevoflurane concentration of maintenance during surgery between the two groups also had no significant difference.After adjusting for factors such as gender,maternal education level,BMI,family income,and anesthesia times,the fine motor ability of the combined intravenous inhalation anesthesia group was worse than that of the inhalation anesthesia group at 12 months post surgery(M12)(P<0.05).CONCLUSIONS:Compared with inhalation anesthesia,combined intravenous and inhalation anesthesia may have a slight effect on the short-term fine motor ability of children after cleft lip and palate surgery under general anesthesia.

关 键 词：唇腭裂手术 全身麻醉 婴幼儿 神经行为发育 盖泽尔发育诊断量表 

分 类 号：R782.05[医药卫生—口腔医学]