【摘要】：目的:探討不同劑量舒芬太尼對(duì)先天性心臟病患兒心臟手術(shù)麻醉中血流動(dòng)力學(xué)以及術(shù)后應(yīng)激反應(yīng)的影響。方法:40例行室缺修補(bǔ)的患兒按隨機(jī)數(shù)字表法分為A、B、C、D組,各10例。A、B、C、D組患兒麻醉誘導(dǎo)時(shí)分別靜脈注射舒芬太尼濃度為0.6、0.8、1.0、1.2μg/kg。記錄4組患兒入室誘導(dǎo)前(T_1)、誘導(dǎo)后(T_2)、插管即刻(T_3)、插管后2 min(T_4)、插管后5 min(T_5)、插管后10 min(T_6)的心率(HR)和收縮壓(SBP)及入室時(shí)(t_1)、插管后(t__2)、劈胸骨后(t_3)、復(fù)溫開(kāi)始時(shí)(t_4)、停機(jī)后10 min(t_5)、術(shù)后24 h(t_6)各時(shí)刻乙酰膽堿(ACH)、皮質(zhì)醇、胰高血糖素、白介素(IL)-6、乳酸水平。結(jié)果:4組患兒HR、SBP水平組間比較,T_1時(shí)刻差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),T_2~T_6各時(shí)刻差異均有統(tǒng)計(jì)學(xué)意義(P0.05);4組患兒ACH、胰高血糖素、IL-6、乳酸水平組間比較,T_1時(shí)刻差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),T_2~T_6時(shí)刻差異均有統(tǒng)計(jì)學(xué)意義(P0.05);皮質(zhì)醇水平在t_1~t_4時(shí)刻差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),t_5~t_6時(shí)刻差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:小兒心臟手術(shù)麻醉中,選擇舒芬太尼的劑量以1.0μg/kg最為適宜,對(duì)患兒血流動(dòng)力學(xué)和術(shù)后應(yīng)激反應(yīng)的影響較小。
[Abstract]:Objective: To investigate the effects of different dose of sufentanil on hemodynamics and post-operative stress response in children with congenital heart disease. Methods:40 children with ventricular septal defect were divided into groups A, B, C and D according to the random number table method. The concentrations of sufentanil in group A, B, C and D were 0.6, 0.8, 1.0 and 1.2. m The rate of heart rate (HR) and systolic blood pressure (SBP) and blood pressure (t _ 1), post-intubation (t _ 2) and sternal time (t _ 3) were recorded in 4 groups (T _ 1), after induction (T _ 2), immediate (T _ 3),2 min (T _ 4),5 min (T _ 5) after intubation,10 min (T _ 6) after intubation, and (t _ 1), after intubation (t _ 2), after the sternal incision (t _ 3), At the beginning of rewarming (t _ 4), after the shutdown,10 min (t _ 5) and 24 h (t _ 6) at the end of the operation, the levels of acetylcholine (ACH), cortisol, glucagon, interleukin (IL)-6, and lactic acid were observed at the time of 24 h (t _ 6). Results: The levels of HR and SBP in four groups were not significant (P0.05), and the difference of T _ 2 and T _ 6 was statistically significant (P0.05). There was no significant difference in the time of T _ 2 ~ T _ 6 (P0.05). There was no significant difference between the time of t _ 1 ~ t _ 4 and the difference of t _ 5 ~ t _ 6 at the time of t _ 1 ~ t _ 4 (P <0.05). Conclusion: The dosage of sufentanil is the most suitable for pediatric cardiac surgery, and the effect of sufentanil on hemodynamics and post-operative stress response in children is less.
【作者單位】： 江蘇省睢寧縣人民醫(yī)院麻醉科;
【分類(lèi)號(hào)】：R726.1

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