血浆谷氨酸与γ-氨基丁酸水平对麻醉后幼儿早期认知功能障碍的相关性研究

发布时间：2018-04-23 11:05

本文选题：幼儿 + 丙泊酚　；参考：《中国临床药理学杂志》2016年06期

【摘要】：目的观察丙泊酚或依托咪酯麻醉对幼儿腹腔镜下疝修补术后早期认知功能及血浆谷氨酸(Glu)与γ-氨基丁酸(GABA)含量的改变,探讨血浆谷氨酸与γ-氨基丁酸水平变化与丙泊酚或依托咪酯麻醉后幼儿早期认知功能障碍的相关性。方法 100例1~3岁拟行择期腹腔镜下疝修补术患儿,随机分为丙泊酚麻醉组(A组)、依托咪酯麻醉组(B组)各50例;50例同年龄段健康幼儿作对照组(C组)。A、B组麻醉诱导分别给予丙泊酚1~3 mg·kg~(-1)、依托咪酯0.1~0.4 mg·kg~(-1)。比较A、B组内及组间术后认知功能障碍组和术后非认知功能障碍组患儿血浆谷氨酸、γ-氨基丁酸含量的变化。结果 A、B组术后3 d发生术后认知功能障碍的例数分别为10例(20.0%)、9例(18.0%,P0.05)。与术前比较,A、B组出麻醉恢复室时非术后认知功能障碍组患儿血浆谷氨酸、γ-氨基丁酸含量略有升高,差异均无统计学意义(P0.05),术后认知功能障碍组患儿血浆谷氨酸、γ-氨基丁酸含量均显著升高(P0.05)。A、B组幼儿出麻醉恢复室时血浆谷氨酸、γ-氨基丁酸含量升高均,与其术后3 d发生术后认知功能障碍正相关(P0.05)。结论血浆谷氨酸、γ-氨基丁酸含量可间接反映麻醉后幼儿发生不同程度的脑损伤,可作为幼儿术后早期发生术后认知功能障碍的检测指标。
[Abstract]:Objective to observe the effects of propofol or etomidate anesthesia on early cognitive function and plasma glutamate and GABA levels after laparoscopic herniorrhaphy in young children. To investigate the relationship between plasma glutamate and 纬-aminobutyric acid levels and cognitive impairment in infants after anesthesia with propofol or etomidate. Methods 100 children (1 ~ 3 years old) with selective laparoscopic herniorrhaphy, They were randomly divided into propofol anesthesia group (n = 50) and etomidate anesthesia group (n = 50). 50 healthy children of the same age group were given propofol (1 3 mg / kg) and etomidate (0. 1 卤0. 4 mg 路kg ~ (-1)) respectively. To compare the changes of plasma glutamate and 纬 -aminobutyric acid levels in children with cognitive impairment and non-cognitive impairment after operation. Results in group A, the number of patients with postoperative cognitive dysfunction on the 3rd day after operation was 20.0 and 18.0 respectively (P 0.05). Plasma glutamate and 纬 -aminobutyric acid levels were slightly increased in patients with non-postoperative cognitive dysfunction during anaesthesia recovery, compared with those before operation. There was no significant difference in plasma glutamate and 纬 -aminobutyric acid levels in children with cognitive impairment after operation. The levels of plasma glutamate and 纬 -aminobutyric acid in group A were significantly higher than those in group A (P 0.05) and the levels of 纬 -aminobutyric acid (纬 -aminobutyric acid) in the recovery chamber of anaesthesia were significantly higher than those in the control group. There was a positive correlation between postoperative cognitive dysfunction and postoperative cognitive dysfunction on the 3rd day after operation (P 0.05). Conclusion the levels of plasma glutamate and 纬 -aminobutyric acid can indirectly reflect the occurrence of different degrees of brain injury in children after anesthesia, and can be used as an index for the detection of postoperative cognitive dysfunction in early postoperative children.
【作者单位】：桂林医学院附属医院麻醉科;
【基金】：广西高校学校科研基金资助项目(201204lx243) 桂林市科学研究与技术开发基金资助项目(20130310-2-3)
【分类号】：R726.1

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