| 纪学武,张伶俐,夏迎静,韩 芬,赵雪梅.七氟烷联合瑞芬太尼对腹股沟斜疝腹腔镜手术患儿苏醒质量、应激反应和细胞免疫功能的影响[J].,2024,(17):3256-3259 |
| 七氟烷联合瑞芬太尼对腹股沟斜疝腹腔镜手术患儿苏醒质量、应激反应和细胞免疫功能的影响 |
| Effects of Sevoflurane Combined with Remifentanil on Awakening Quality, Stress Response and Cellular Immune Function in Children with Indirect Inguinal Hernia Undergoing Laparoscopic Operation |
| 投稿时间：2024-03-24 修订日期：2024-04-21 |
| DOI：10.13241/j.cnki.pmb.2024.17.011 |
| 中文关键词: 七氟烷 瑞芬太尼 腹股沟斜疝 腹腔镜手术 苏醒质量 应激反应 免疫功能 |
| 英文关键词: Sevoflurane Remifentanil Indirect inguinal hernia Laparoscopic operation Awakening quality Stress response Immune function |
| 基金项目:安徽省自然科学基金面上项目（1808085MH230） |
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| 中文摘要: |
| 摘要 目的：观察七氟烷联合瑞芬太尼对腹股沟斜疝腹腔镜手术患儿苏醒质量、应激反应和细胞免疫功能的影响。方法：采用随机数字表法将我院2023年11月~2024年1月期间接收的102例腹股沟斜疝患儿分为对照组（51例，麻醉方案采用丙泊酚联合瑞芬太尼）与观察组（51例，麻醉方案采用七氟烷联合瑞芬太尼）。对比两组血流动力学指标[心率（HR）、收缩压（SBP）、舒张压（DBP）]、苏醒情况[拔管、清醒、呼吸恢复时间]、应激反应指标（血糖和血浆皮质醇）以及细胞免疫功能（CD4+、CD8+、CD4+/CD8+），统计比较两组不良反应发生率。结果：观察组切皮后10 min、拔管时的HR、SBP、DBP相比对照组更高（P<0.05）。观察组清醒、拔管、呼吸恢复时间均较对照组更短（P<0.05）。观察组切皮时、拔管时血糖、皮质醇相比对照组更低（P<0.05）。观察组术后12 h CD4+、CD4+/CD8+相比对照组更高，CD8+相比对照组更低（P<0.05）。不良反应总发生率：对照组的为9.80%，观察组的为11.76%，两组对比无差异（P>0.05）。结论：腹股沟斜疝腹腔镜手术患儿麻醉药物选用瑞芬太尼、七氟烷方案，可维持血流动力学稳定，提高苏醒质量，减轻应激反应，减轻免疫抑制。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of sevoflurane combine with remifentanil on awakening quality, stress response and cellular immune function in children with indirect inguinal hernia undergoing laparoscopic operation. Methods: 102 children with indirect inguinal hernia received in our hospital from November 2023 to January 2024 were divided into control group (51 cases, anesthesia regimen was remifentanil) and observation group (51 cases, anesthesia regimen was Propofol combined with remifentanil) by random number table method.The hemodynamic indexes [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)], Awakening situation [time of awakening, extubation and respiratory recovery], stress response indexes (blood glucose and plasma cortisol) and cellular immune function (CD4+, CD8+, CD4+/CD8+) were compared in two groups, the incidence of adverse reactions was statistically compared in two groups. Results: HR, SBP and DBP at 10 min after skin incision and extubation in observation group were higher than those in control group (P<0.05). The time of awakening, extubation and respiratory recovery in observation group were shorter than those in control group(P<0.05). The blood glucose and cortisol in observation group were lower than those in control group at the time of skin incision and extubation (P<0.05). 12 h after operation, CD4+ and CD4+/CD8+ in observation group were higher than those in control group, and CD8+ was lower than that in control group (P<0.05). The total incidence of adverse reactions: control group was 9.80%; observation group was 11.76%, there was no difference in two groups (P>0.05). Conclusion: Remifentanil and sevoflurane are selected as anesthetic drugs for children with indirect inguinal hernia undergoing laparoscopic operation, which can maintain hemodynamic stability, improve awakening quality, reduce stress response and relieve immunosuppression. |
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