CAJ | 학술논문

[目的]应用无创心功能监测仪（NICOM ）观察小儿腹腔镜手术中右美托咪定（DEX ）联合七氟烷对患儿心功能的影响。[方法]选择28例，ASA Ⅰ～Ⅱ级，择期全麻下行腹腔镜手术的患儿，年龄2～10岁，体重14～45 kg。麻醉诱导和维持时加用DEX ，DEX 负荷剂量为0．1μg/（kg · min），维持剂量为0．01μg/（kg · min）微泵持续滴注10 min。应用NICOM 监测对比两组患儿入室时（T1）、术中气腹前（T2）、术中气腹时（T3）、术毕后15 min（T4）心率（HR）、动脉收缩压（SABP）、每博输出量（SV）、心排量（CO）、心指数（CI）等指标变化。[结果]比较发现在T2和T3时HR指标与基础值相比均有统计学差异（ P ＜0．05），其余指标在任何时间段均无统计学差异（ P ＞0．05）。[结论]在儿童患者腹腔镜手术时复合应用DEX ，对心率的抑制比较明显，对心功能基本无影响。
[목적]응용무창심공능감측의（NICOM ）관찰소인복강경수술중우미탁미정（DEX ）연합칠불완대환인심공능적영향。[방법]선택28례，ASA Ⅰ～Ⅱ급，택기전마하행복강경수술적환인，년령2～10세，체중14～45 kg。마취유도화유지시가용DEX ，DEX 부하제량위0．1μg/（kg · min），유지제량위0．01μg/（kg · min）미빙지속적주10 min。응용NICOM 감측대비량조환인입실시（T1）、술중기복전（T2）、술중기복시（T3）、술필후15 min（T4）심솔（HR）、동맥수축압（SABP）、매박수출량（SV）、심배량（CO）、심지수（CI）등지표변화。[결과]비교발현재T2화T3시HR지표여기출치상비균유통계학차이（ P ＜0．05），기여지표재임하시간단균무통계학차이（ P ＞0．05）。[결론]재인동환자복강경수술시복합응용DEX ，대심솔적억제비교명현，대심공능기본무영향。
[Objective] To observe the impact of intraoperative dexmedetomidine (Dex ) combined with sevoflurane on cardiac function of children during laparoscopy by using noninvasive continuous cardiac output monitoring(NICOM ) .[Methods] Twenty-eight children with ASA Ⅰ ~ Ⅱ who were scheduled for elective laparoscopic surgery were chosen .Their age was 2~10 years ,and weight was 14~45kg .All patients received additional pump infusion of Dex with priming dose of 0 .1 μg/(kg · min) and maintenance dose of 0 .01μg/(kg · min) for anesthesia induction and maintenance for 10min .NICOM was used to monitor and compare the changes of indicators such as heart rate (HR) ,arterial systolic pressure(SABP) ,stroke volume(SV ) ,cardiac output(CO)andcardiacindex(CI)beforeinduction(T1),beforeintraoperativepneumoperitoneum(T2),atin-traoperative pneumoperitoneum(T3 ) and 15min after operation(T4 ) .[Results] There was significant differ-ences in HR indicators and baseline value between T 2 and T3 ( P <0 .05) ,but there was no significant differ-ence in other indicators at each time( P>0 .05) .[Conclusion] The combination application of DEX in children undergoing laparoscopic surgery has obvious inhibition on heart rate ,but has no impact on cardiac function .