| 张 旭,邱庆琢,宋海成,胡逸非,任悦义.右美托咪定复合七氟醚对先天性心脏病介入封堵术患儿血流动力学、氧化应激反应和心肌损伤的影响[J].,2021,(23):4588-4592 |
| 右美托咪定复合七氟醚对先天性心脏病介入封堵术患儿血流动力学、氧化应激反应和心肌损伤的影响 |
| Effects of Dexmedetomidine Combined with Sevoflurane on Hemodynamics, Oxidative Stress Reaction and Myocardial Injury in Children With Congenital Heart Disease Undergoing Transcatheter Closure |
| 投稿时间：2021-05-23 修订日期：2021-06-17 |
| DOI：10.13241/j.cnki.pmb.2021.23.040 |
| 中文关键词: 右美托咪定 七氟醚 先天性心脏病 介入封堵术 血流动力学 氧化应激 心肌损伤 |
| 英文关键词: Dexmedetomidine Sevoflurane Congenital heart disease Transcatheter closure Hemodynamics Oxidative stress Myocardial injury |
| 基金项目:山东省自然科学基金项目（ZR2013HM012） |
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| 摘要 目的：观察右美托咪定复合七氟醚对先天性心脏病（CHD）介入封堵术患儿血流动力学、心肌损伤和氧化应激反应的影响。方法：选择2016年1月-2020年12月期间在我院择期行介入封堵术的CHD患儿 106例。按照住院号奇偶顺序将患儿分为对照组（七氟醚麻醉）和观察组（右美托咪定复合七氟醚麻醉），各53例。观察两组围术期间的血流动力学、氧化应激反应和心肌损伤指标变化情况，记录两组患儿苏醒即刻的躁动评分和镇静评分、苏醒时间和围术期间的不良反应发生率。结果：两组T0~T4时间点心率（HR）均呈先升高后降低趋势，平均动脉压（MAP）均呈先降低后升高趋势（P<0.05）。术后24 h，观察组血清超氧化物歧化酶(SOD)水平高于对照组，丙二醛(MDA)水平低于对照组（P<0.05）。术后24 h，观察组血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白 I(cTnI)、心脏型脂肪酸结合蛋白(H-FABP)水平均低于对照组（P<0.05）。观察组苏醒即刻的躁动评分低于对照组（P<0.05）。两组患儿不良反应总发生率对比无差异（P>0.05）。结论：右美托咪定复合七氟醚应用于行介入封堵术的CHD患儿，可减少躁动发生情况，同时不影响患儿血流动力学和苏醒情况，在减轻氧化应激、心肌损伤方面亦有一定的积极意义。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of dexmedetomidine combined with sevoflurane on hemodynamics, myocardial injury and oxidative stress reaction in children with congenital heart disease (CHD) undergoing transcatheter closure. Methods: From January 2016 to December 2020, 106 children with CHD undergoing transcatheter closure in our hospital were selected. According to the hospitalization number odd-even order, the children were divided into control group (sevoflurane) and observation group (dexmedetomidine combined with sevoflurane), 53 cases in each group. The hemodynamics, oxidative stress reaction and myocardial injury indexes during the perioperative period of the two groups were observed. The the agitation score immediately after awakening, awakening time, the sedation score immediately after awakening and the incidence of perioperative adverse reactions were recorded in two groups. Results: Heart rate (HR) at T0~T4 time points in two groups showed a trend of increasing firstly and then decreasing, mean arterial pressure (MAP) was firstly decreased and then increased (P<0.05). 24 h after operation, the serum superoxide dismutase (SOD) level in observation group was higher than that in control group, and the serum malondialdehyde (MDA) level was lower than that of control group (P<0.05). 24 h after operation, the serum creatine kinase isoenzyme (CK-MB), cardiac troponin I(cTnI) and cardiac fatty acid binding protein (H-FABP) levels in observation group were lower than those in control group (P<0.05). The score of agitation score immediately after awakening in the observation group was lower than that in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: The application of dexmedetomidine combined with sevoflurane in children with CHD undergoing transcatheter closure can reduce the occurrence of agitation, and does not affect the hemodynamics and recovery of children. It also has certain positive significance in reducing oxidative stress and myocardial injury. |
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