表面麻醉下ROP激光光凝术患儿的疼痛评估.docVIP

表面麻醉下早产儿视网膜病变激光光凝术患儿应激反应的研究 谢婉花1，2 ,李亚洁1? ,项道满2,陈锋2,陈正珊2,刘佩珍2 (1.南方医科大学南方医院 临床护理教研室，广东 广州510515; 2.广州市妇女儿童医疗中心,广东 广州 510623) [摘 要]目的 研究表面麻醉下ROP激光光凝术患儿的应激反应，为临床采取干预措施提供科学依据。方法 抽取30例ROP激光光凝术患儿在术前安静状态、手术结束时、术后1h、术后24h的静脉血，检测血中多巴胺、去甲肾上腺素、肾上腺素的浓度。结果 多巴胺、去甲肾上腺素、肾上腺素的浓度组间比较差异有统计学意义（P＜0.05）；手术结束时上述3个指标均高于安静状态的水平（P＜0.05）；术后1h患儿多巴胺、去甲肾上腺素的浓度高于术前安静状态的水平（P＜0.05）。HR、SpO2、RR、MBP的数值组间比较差异具有统计学意义（P＜0.05）。 结论 表面麻醉下接受ROP激光光凝术治疗的患儿在术中会产生应激反应，而且这种应激状态在术后1h时仍然存在，提示自手术开始至术后1小时内应加强观察。 [关键词] 早产儿视网膜病变；光凝术；应激反应 Research on Stress Response of Infants in Laser Photocoagulation for Retinopathy of Prematurity with Topical Anesthesia Xie Wan-hua1,2，Li Ya-jie1，Xiang Dao-man2，Chen Feng2，Chen Zheng-shan2 , Liu Pei-zhen2 Clinical Nursing Teaching Office,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;2.Guangzhou Women and Children’s Medical Center) Abstract： Objective To investigate stress response of infants during the laser photocoagulation for retinopathy of prematurity(ROP) with topical anesthesia and provide scientific evidences for clinical interventions. Methods Infants(n=30) who needed laser photocoagulation for retinopathy of prematurity were collected venous blood at four time points: preoperative quiet state, the end of operation, 1 hour and 24 hours after operation. The concentrations of dopamine, norepinephrine and epinephrine in plasma were measured. Results Concentrations of dopamine, norepinephrine and epinephrine had statistical significance in comparison among groups（P＜0.05）. At the end of operation, concentrations of three indexes above were all higher than that in preoperative quiet state(P＜0.05). Concentrations of dopamine and noradrenaline at 1 hour after operation were higher than that in preoperative quiet state（P＜0.05）. HR、SpO2、RR and MBP had statistical significance in comparison among grops（P＜0.05）.Conclusion Infants had stress response during ROP laser photocoagulation with topical anesthesia and the reaction still existed _________________