【摘要】：目的研究酮咯酸氨丁三醇超前鎮(zhèn)痛對小兒腹腔鏡手術(shù)應(yīng)激反應(yīng)及血漿血栓素A2(TXA2)和血小板顆粒膜蛋白(GMP140)水平的影響。方法將60例年齡2~12歲、ASA I~II級擇期腹腔鏡手術(shù)患兒以抽簽法隨機(jī)分為“T組”和“C組”各30例,T組在麻醉誘導(dǎo)前給予酮咯酸氨丁三醇進(jìn)行超前鎮(zhèn)痛,C組在麻醉誘導(dǎo)前給予生理鹽水,兩組的麻醉誘導(dǎo)和維持方案相同。比較兩組患兒的應(yīng)激反應(yīng)、氧化損傷、血小板活化、不良反應(yīng)情況。結(jié)果(1)T組術(shù)后30min、6h皮質(zhì)激素、腎上腺素、去甲腎上腺素水平均低于C組(P0.05),而術(shù)后24h與C組比較差異無統(tǒng)計學(xué)意義(P0.05);(2)T組術(shù)后30min GMP-140水平均低于C組(P0.05);(3)T組不良反應(yīng)發(fā)生率6.67%(2/30)低于C組的13.33%(4/30)。結(jié)論對于小兒腹腔鏡手術(shù),采用酮咯酸氨丁三醇超前鎮(zhèn)痛能有效抑制應(yīng)激反應(yīng)和血小板激活,同時降低不良反應(yīng)發(fā)生率。
[Abstract]:Objective to study the effects of preemptive analgesia with ketoclorobutanol on stress response, plasma thromboxane A 2 (TXA2) and platelet granule membrane protein (GMP140) levels in children undergoing laparoscopic surgery. Methods 60 patients with ASA I~II grade elective laparoscopic surgery aged 2 or 12 years were randomly divided into "T group" and "C group" (30 cases each) before induction of anesthesia. Group C was given preemptive analgesia before anesthesia induction. Give normal saline before guide, The induction and maintenance of anesthesia were the same in both groups. Stress reaction, oxidative injury, platelet activation and adverse reaction were compared between the two groups. Results (1) the levels of corticosteroids, epinephrine and norepinephrine in group T were lower than those in group C at 30 min after operation (P0.05), but there was no significant difference between group C and group C at 24 hours after operation (P0.05); (2). The incidence of adverse reactions in group T was lower than that in group C (P0.05); (3) 6.67% (2 / 30) lower than that in group C 13.33% (4 / 30). Conclusion preemptive analgesia with ketoclorobutanol can effectively inhibit stress response and platelet activation, and reduce the incidence of adverse reactions for children undergoing laparoscopic surgery.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R726.5

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