本文選題：右美托咪定 + 應(yīng)激反應(yīng)　； 參考：《廣東醫(yī)學(xué)》2017年19期

【摘要】：目的探討右美托咪定(Dex)對(duì)經(jīng)食管超聲引導(dǎo)下胸壁微創(chuàng)室間隔缺損封堵術(shù)小兒應(yīng)激反應(yīng)的影響。方法擇期行經(jīng)食管超聲引導(dǎo)下胸壁微創(chuàng)室間隔缺損封堵術(shù)患兒60例,ASAⅠ~Ⅱ級(jí),隨機(jī)分成D組和C組,每組30例。D組麻醉誘導(dǎo)前10 min靜脈泵注Dex 0.5μg/kg,術(shù)中分別持續(xù)靜脈泵注Dex 0.5μg/(kg·h)至術(shù)畢;C組麻醉誘導(dǎo)前10 min靜脈泵注丙泊酚1 mg/kg,術(shù)中持續(xù)靜脈泵注丙泊酚5 mg/(kg·h)至術(shù)畢。記錄給藥前(T0)、給藥后10 min(T1)、氣管插管后即刻(T2)、切皮后(T3)、放置封堵器時(shí)(T4)、拔管時(shí)(T5)和拔管后10min(T6)的收縮壓(SBP)、舒張壓(DBP)、心率(HR)、呼吸頻率(RR)、血氧飽和度(SpO_2)和BIS值;分別測(cè)定T0、T2、T4和T6的血糖(BG)、血漿促腎上腺皮質(zhì)激素(ACTH)、皮質(zhì)醇(Cor)、胰高血糖素(GN)、乳酸(LAC)濃度。結(jié)果 D組的HR在T1、T2、T3、T4和T5時(shí)點(diǎn)明顯慢于C組(P0.05);D組的SBP在T2、T3和T4時(shí)明顯低于C組(P0.05)。C組LAC濃度在T4和T6時(shí)明顯高于T0和T2(P0.05);D組BG、ACTH、Cor、GN和LAC濃度在T4和T6時(shí)點(diǎn)明顯低于C組(P0.05),且D組ACTH濃度在T2時(shí)點(diǎn)明顯低于C組(P0.05);D組和C組BG、ACTH、Cor和GN的濃度在T4和T6時(shí)明顯高于T0和T2(P0.05);D組和C組Cor和GN在T6時(shí)明顯高于T4(P0.05)。結(jié)論 Dex在小兒經(jīng)食管超聲引導(dǎo)下胸壁微創(chuàng)室間隔缺損封堵術(shù)應(yīng)用,能有效抑制圍手術(shù)期HR的增快和血壓的升高,維持血流動(dòng)力學(xué)穩(wěn)定和適當(dāng)?shù)逆?zhèn)靜深度,有效減輕應(yīng)激反應(yīng)。
[Abstract]:Objective to investigate the effect of dexmetomidine Dexon on stress response in children undergoing transesophageal ultrasound-guided minimally invasive closure of ventricular septal defect (VSD). Methods Sixty children with thoracic wall minimally invasive ventricular septal defect (VSD) were randomly divided into group D and group C after selective transesophageal ultrasound guided minimally invasive ventricular septal defect closure (ASA 鈪，

本文編號(hào)：1820216