CAJ | 학술논문

目的研究表面麻醉下早产儿视网膜病变激光光凝术患儿的应激反应,为临床采取干预措施提供科学依据.方法抽取30例早产儿视网膜病变激光光凝术患儿在术前安静状态、手术结束时、术后1 h、术后24 h的静脉血,检测血中多巴胺、去甲肾上腺素、肾上腺素的浓度,以及记录这4个时间点的心率、血氧饱和度、呼吸、平均动脉压.结果多巴胺、去甲肾上腺素、肾上腺素的浓度组间比较差异有统计学意义(P<0.05);手术结束时上述3个指标,术后1 h患儿多巴胺、去甲肾上腺素的浓度高于术前安静状态的水平(P<0.05).心率、血氧饱和度、呼吸、平均动脉压的数值组间比较差异有统计学意义(P<0.01).术后24 h患儿心率、血氧饱和度、呼吸与术前安静状态的水平相比,差异有统计学意义(P<0.05).结论表面麻醉下接受早产儿视网膜病变激光光凝术治疗的患儿在术中会产生应激反应,而且这种应激状态在术后24 h时仍然存在,提示自手术开始至术后24 h内应加强观察和护理.
목적연구표면마취하조산인시망막병변격광광응술환인적응격반응,위림상채취간예조시제공과학의거.방법추취30례조산인시망막병변격광광응술환인재술전안정상태、수술결속시、술후1 h、술후24 h적정맥혈,검측혈중다파알、거갑신상선소、신상선소적농도,이급기록저4개시간점적심솔、혈양포화도、호흡、평균동맥압.결과다파알、거갑신상선소、신상선소적농도조간비교차이유통계학의의(P<0.05);수술결속시상술3개지표,술후1 h환인다파알、거갑신상선소적농도고우술전안정상태적수평(P<0.05).심솔、혈양포화도、호흡、평균동맥압적수치조간비교차이유통계학의의(P<0.01).술후24 h환인심솔、혈양포화도、호흡여술전안정상태적수평상비,차이유통계학의의(P<0.05).결론표면마취하접수조산인시망막병변격광광응술치료적환인재술중회산생응격반응,이차저충응격상태재술후24 h시잉연존재,제시자수술개시지술후24 h내응가강관찰화호리.
@@@@Objective To investigate stress response of infants during the laser photocoagulation for retinopathy of prematurity (ROP) with topical anesthesia and provide scientific evidences for clinical interventions. Methods Venous blood of infants (n=30) who needed laser photocoagulation for ROP were sampled at four time points:preoperative quiet state, the end of operation, 1 hour and 24 hours after operation. The concentrations of dopamine, norepinephrine and epinephrine in plasma were measured and physiological parameters as heart rate (HR), oxygen saturation of blood (SpO2), respiratory rate (RR) and mean blood pressure (MBP) were recorded at the same time points. Results The comparison of concentrations of dopamine, norepinephrine and epinephrine had statistical significance among groups (P<0.05). At the end of operation, concentrations of dopamine, norepinephrine and epinephrine and those of dopamine, norepinephrine at 1 hour after operation were all higher than those in preoperative quiet state (P<0.05). The comparison of HR, SpO2, RR and MBP had statistical significance among groups (P<0.01). The HR, SpO2 and RR at 24 hours after operation had statistical significance when compared with those in preoperative quiet state (P<0.05). Conclusion Infants of ROP have stress response during laser photocoagulation with topical anesthesia and the reaction still exists 24 hours after operation. It suggests that sophisticated monitoring and care from the beginning of operation to 24 hour after operation are indispensible.