右美托咪定对紫绀型先天性心脏病患儿体外循环应激反应的影响邱永升.docVIP

PAGE PAGE 3 右美托咪定对紫绀型先天性心脏病患儿体外循环应激反应的影响 邱永升 贾英萍 徐庆 基金项目：河南省郑州市科技发展计划基金 作者单位：450053 郑州市儿童医院（邱永升 贾英萍）； 100730 中国医学科学院 北京协和医院（徐庆） 通信作者：邱永升Email： qysh66@126.com 【摘要】目的 研究婴幼儿紫绀型先天性心脏病（CHD）患儿体外循环（CPB）下应用右美托咪定(Dex)对应激反应的影响。方法 经医院伦理委员会批准，患儿监护人签署知情同意书，随机选择40例婴幼儿紫绀型CHD患儿，按照随机数字分组法分为试验组（A组）和对照组（C组），每组20人。全麻后A组给予Dex1μg/kg，注射时间＞10min，术中0.2μg?kg-1?h-1静脉泵入，直至手术结束。C组在整个手术过程静注0.9%生理盐水，输注速度、麻醉处理和A组一致。分别于输注Dex前（T1）、给药后10min（T2）、劈胸骨后（T3）、CPB结束时（T4）、手术结束时（T5）测定血浆皮质醇、肾上腺素、去甲肾上腺素、血糖浓度。结果 两组患儿的一般情况差异无统计学意义（P0.05），T3～T5时C组患儿血浆皮质醇、肾上腺素、去甲肾上腺素、血糖浓度显著升高， A组在相应时点各项指标明显低于C组。两组间患儿围术期的心率、血压等血流动力学指标差异无统计学意义（P0.05）。结论 Dex能够降低CHD患儿CPB引起的应激激素水平的上升幅度，减轻CPB导致的应激反应。 【关键词】右美托咪定；婴幼儿；体外循环；应激反应 Dexmedetomidine on the clinical studies of stress reaction in infant after cardiopulmonary bypass QIU Yong-sheng,JIA Ying-ping. Department of Anesthesiology,Zhengzhou Children’s Hospital, Zhengzhou 450053,China. XU Qing Department of Anesthesiology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing,China Corresonding author: XU Qing, Email：qysh66@126.com 【Abstract】 Objective To observe the effect of application of dexmedetomidine on stress reaction in infants after cardiopulmonary bypass. Methods Forty cases of cyanotic type? congenital heart disease cardiac malformation, such as operation were divided into two groups, each group of 20 people, namely A and C groups. After A group load received dexmedetomidine 1μg/kg, in 0.2μg?kg-1?h-1 intravenous infusion, until the end of operation. Group C intravenous normal saline in the whole operation process, infusion speed is the same as the experimental group, anesthesia and experimental group agreement. Respectively before the operation (T1), after administration of 10min (T2), after sternotomy (T3),at the end of CPB (T4), at the end of operation (T5) to take blood samples sent to laboratory and collecting records of perioperative data.Results There were no significant in two groups of infants age, weight, operation tim