酮咯酸氨丁三醇超前镇痛对小儿腹腔镜手术应激反应的影响

发布时间：2018-09-14 09:11

【摘要】：目的研究酮咯酸氨丁三醇超前镇痛对小儿腹腔镜手术应激反应及血浆血栓素A2(TXA2)和血小板颗粒膜蛋白(GMP140)水平的影响。方法将60例年龄2~12岁、ASA I~II级择期腹腔镜手术患儿以抽签法随机分为“T组”和“C组”各30例,T组在麻醉诱导前给予酮咯酸氨丁三醇进行超前镇痛,C组在麻醉诱导前给予生理盐水,两组的麻醉诱导和维持方案相同。比较两组患儿的应激反应、氧化损伤、血小板活化、不良反应情况。结果(1)T组术后30min、6h皮质激素、肾上腺素、去甲肾上腺素水平均低于C组(P0.05),而术后24h与C组比较差异无统计学意义(P0.05);(2)T组术后30min GMP-140水平均低于C组(P0.05);(3)T组不良反应发生率6.67%(2/30)低于C组的13.33%(4/30)。结论对于小儿腹腔镜手术,采用酮咯酸氨丁三醇超前镇痛能有效抑制应激反应和血小板激活,同时降低不良反应发生率。
[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.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.5

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