不同剂量羟考酮对体外循环下心内直视手术患儿肺损伤影响.docVIP

不同剂量羟考酮对体外循环下心内直视手术患儿肺损伤的影响 　　[摘要] 目的 探?不同剂量羟考酮对体外循环（CPB）下心内直视手术患儿肺损伤的影响。 方法 选择择期CPB下行室间隔缺损修补术患儿60例，随机分为4组各15例，其中C组（对照组）术中给予等容量生理盐水；D1（低剂量羟考酮）组术中给予羟考酮0.08 mg/（kg?h）；D2（中剂量羟考酮）组术中给予羟考酮0.12 mg/（kg?h）；D3（高剂量羟考酮）组术中给予羟考酮0.15 mg/（kg?h）；直至手术结束。对比四组患儿给药前（T1）、停CPB后2 h（T2）、6 h（T3）和12 h（T3）时，血浆中TNF-α、IL-6和IL-8的含量，患儿桡动脉血血气分析结果，并计算患儿呼吸指数（RI）、氧合指数（OI）与肺顺应性（CL）。 结果 D2、D3组与C组相比，T2、T3、T4时血浆中TNF-α和IL-8的含量明显降低，T3、T4时血浆中IL-6的含量明显降低（P0.05）；D2、D3组与D1组相比，T2、T3、T4时血浆中TNF-α和IL-8的含量及RI明显降低，而OI与CL升高，D2组T3、T4时与D3组T2、T3、T4时血浆中IL-6的含量明显降低（P0.05）；D3组与D2组相比，T2、T3、T4时血浆中IL-8的含量及RI明显降低，T2、T3时TNF-α、IL-6明显降低，而OI与CL升高（P0.05）。 结论 羟考酮可以减轻CPB下心内直视手术患儿肺损伤程度，改善患儿肺功能，且在一定范围内与剂量呈正相关，这可能与其可以抑制CPB诱发的炎症反应相关。 　　[关键词] 羟考酮；体外循环；室间隔修补术；肺损伤 　　[中图分类号] R726.1 [文献标识码] A [文章编号] 1673-9701（2017）35-0009-03 　　[Abstract] Objective To investigate the effects of different doses of oxycodone on lung injury in children with open-heart surgery by cardiopulmonary bypass （CPB）. Methods A total of 60 patients with ventricular septal defect repair by CBP on selective time were selected and were divided into four groups according to a random number table， each group had 15 cases， among them， Group C （control group） was given equal volume of saline； D1 （low dose of oxycodone） group was given oxycodone 0.08 mg/（kg?h）； D2（medium dose of oxycodone） group was give oxycodone 0.12 mg/（kg?h）； D3 （high dose of oxycodone） group was given oxycodone 0.15 mg/（kg?h）； Until the end of the surgery. Before given drug（t1）， after CBP 2 h（t2）， 6 h（T3） and 12 h （T3）， the TNF-α， IL-6 and IL-8 in plasma of the four groups and the results of the analysis of the radial arterial blood gas in children were compared respectively； the respiratory index（RI）， oxygen index（OI） and lung compliance（CL） of the children were calculated and the changes were analyzed. Results Group D2 and D3 compared with group C， the serum TNF alpha and IL-8 levels were significantly lower at T2， T3， and T4， the serum content of IL-6 was significantly lower at T3 and T4 （P 　　[Key w