中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
33期
23-25
,共3页
焦虑%血流动力学%儿童,学龄前%应激反应%右美托咪定
焦慮%血流動力學%兒童,學齡前%應激反應%右美託咪定
초필%혈류동역학%인동,학령전%응격반응%우미탁미정
Anxiety%Hemodynamics%Child,preschool%Stress reaction%Dexmedetomidine
目的 探讨术前应用右美托咪定对学龄前儿童术前配合程度、术中血流动力学的影响.方法 选择择期行下腹部手术的学龄前患儿100例,按随机数字表法分为治疗组和对照组,每组50例.治疗组采用右美托咪定0.5μu/g(稀释至20 ml),对照组为等容量0.9％氯化钠,单次静脉微量泵注,20 min内注射完毕.采用诱导期合作度量表(ICC)评定患儿诱导期合作程度;记录围手术期监测病房泵注前(T1)、病房泵注结束(T2)、麻醉诱导前(T3)、麻醉诱导后(T4)、手术切皮时(T5)、手术结束即刻(T6)平均动脉压(MAP)、心率、脉搏血氧饱和度(SpO2),呼气末二氧化碳分压(PE.TCO2)变化.结果 治疗组ICC评分为(2.73±0.12)分,明显低于对照组的(6.17±0.91)分,差异有统计学意义(P＜0.05).治疗组ICC评分0分48例,ICC评分＞5分2例;对照组ICC评分0分3例,ICC评分＞5分47例,两组比较差异有统计学意义(P＜0.05).两组T1、T2、T4时MAP、心率比较差异无统计学意义(P＞0.05);治疗组T3、T5、T6时MAP、心率明显低于对照组,差异有统计学意义(P＜0.05).对照组T3、T5、T6时MAP、心率明显高于本组T1时,差异有统计学意义(P＜0.05).治疗组患儿各时间点MAP、心率与本组T1比较差异无统计学意义(P＞0.05).两组间和组内各时间点SpO2、PETCO2比较差异无统计学意义(P＞0.05).结论 术前应用右美托咪定干预,麻醉诱导及手术平稳,患儿康复时间缩短.
目的 探討術前應用右美託咪定對學齡前兒童術前配閤程度、術中血流動力學的影響.方法 選擇擇期行下腹部手術的學齡前患兒100例,按隨機數字錶法分為治療組和對照組,每組50例.治療組採用右美託咪定0.5μu/g(稀釋至20 ml),對照組為等容量0.9％氯化鈉,單次靜脈微量泵註,20 min內註射完畢.採用誘導期閤作度量錶(ICC)評定患兒誘導期閤作程度;記錄圍手術期鑑測病房泵註前(T1)、病房泵註結束(T2)、痳醉誘導前(T3)、痳醉誘導後(T4)、手術切皮時(T5)、手術結束即刻(T6)平均動脈壓(MAP)、心率、脈搏血氧飽和度(SpO2),呼氣末二氧化碳分壓(PE.TCO2)變化.結果 治療組ICC評分為(2.73±0.12)分,明顯低于對照組的(6.17±0.91)分,差異有統計學意義(P＜0.05).治療組ICC評分0分48例,ICC評分＞5分2例;對照組ICC評分0分3例,ICC評分＞5分47例,兩組比較差異有統計學意義(P＜0.05).兩組T1、T2、T4時MAP、心率比較差異無統計學意義(P＞0.05);治療組T3、T5、T6時MAP、心率明顯低于對照組,差異有統計學意義(P＜0.05).對照組T3、T5、T6時MAP、心率明顯高于本組T1時,差異有統計學意義(P＜0.05).治療組患兒各時間點MAP、心率與本組T1比較差異無統計學意義(P＞0.05).兩組間和組內各時間點SpO2、PETCO2比較差異無統計學意義(P＞0.05).結論 術前應用右美託咪定榦預,痳醉誘導及手術平穩,患兒康複時間縮短.
목적 탐토술전응용우미탁미정대학령전인동술전배합정도、술중혈류동역학적영향.방법 선택택기행하복부수술적학령전환인100례,안수궤수자표법분위치료조화대조조,매조50례.치료조채용우미탁미정0.5μu/g(희석지20 ml),대조조위등용량0.9％록화납,단차정맥미량빙주,20 min내주사완필.채용유도기합작도량표(ICC)평정환인유도기합작정도;기록위수술기감측병방빙주전(T1)、병방빙주결속(T2)、마취유도전(T3)、마취유도후(T4)、수술절피시(T5)、수술결속즉각(T6)평균동맥압(MAP)、심솔、맥박혈양포화도(SpO2),호기말이양화탄분압(PE.TCO2)변화.결과 치료조ICC평분위(2.73±0.12)분,명현저우대조조적(6.17±0.91)분,차이유통계학의의(P＜0.05).치료조ICC평분0분48례,ICC평분＞5분2례;대조조ICC평분0분3례,ICC평분＞5분47례,량조비교차이유통계학의의(P＜0.05).량조T1、T2、T4시MAP、심솔비교차이무통계학의의(P＞0.05);치료조T3、T5、T6시MAP、심솔명현저우대조조,차이유통계학의의(P＜0.05).대조조T3、T5、T6시MAP、심솔명현고우본조T1시,차이유통계학의의(P＜0.05).치료조환인각시간점MAP、심솔여본조T1비교차이무통계학의의(P＞0.05).량조간화조내각시간점SpO2、PETCO2비교차이무통계학의의(P＞0.05).결론 술전응용우미탁미정간예,마취유도급수술평은,환인강복시간축단.
Objective To explore the degree of cooperation and the effect of hemodynamics in preschool children who received preoperative use of dexmedetomidine.Methods One hundred preschool children who scheduled for lower abdominal operation were randomly divided into two groups,each 50patients.The treatment group was given bolus infusion dexmedetomidine 0.5 μ g/kg (20 ml),the control group was given bolus infusion 0.9％ sodium chloride 20 ml.They were completed in 20 min.The cooperation was assessed by induction compliance checklist (ICC) score,and the level of mean arterial pressure (MAP),heart rate(HR),pulse oxygen saturation(SpO2),end-tidal pressure of carbon dioxide(PnCO2) at monitoring ward before bolus infusion (T1),end of bolus infusion (T2),before induction (T3),after induction (T4),incised skin (T5) and end of operation (T6) were compared.Results The scores ofICC in treatment group was significantly lower than that in control group [(2.73 ± 0.12) scores vs.(6.17 ± 0.91) scores] (P ＜ 0.05).In treatment group,48 patients ICC score was 0,2 patients ICC score ＞5 scores,and in control group,there was 48,2 patients,there was significant difference(P ＜ 0.05).The level of MAP,HR at T1,T2,T4between two groups had no significant difference (P ＞ 0.05).The level of MAP,HR at T3,T5,T6 in treatment group were significantly lower than those in control group(P ＜ 0.05).In control group,the level of MAP,HR at T3,T5,T6 were significantly higher than those at T1 (P ＜ 0.05).In treatment group,the level of MAP,HR at T2-T6 had no significant difference compared with T1 (P ＞ 0.05).The level of SpO2,PnCO2 between two groups and interclass had no significant difference (P ＞0.05).Conclusion Bolus infusion dexmedetomidine before operation can improve the induction of anesthesia and operation smoothly,and improve the patients early rehabilitation.
