| 李月琴,康 立,袁 晴,王 谦,钱 秋.丙泊酚联合七氟醚麻醉在先天性心脏病介入手术患儿中的心肌保护作用及对苏醒质量和应激反应的影响[J].,2023,(9):1791-1795 |
| 丙泊酚联合七氟醚麻醉在先天性心脏病介入手术患儿中的心肌保护作用及对苏醒质量和应激反应的影响 |
| Myocardial Protective Effect Study of Propofol Combined with Sevoflurane Anesthesia in Children Undergoing Interventional Surgery for Congenital Heart Disease and its Effect on Awakening Quality and Stress Response |
| 投稿时间：2022-09-21 修订日期：2022-10-17 |
| DOI：10.13241/j.cnki.pmb.2023.09.037 |
| 中文关键词: 丙泊酚 七氟醚 麻醉 先天性心脏病 介入手术 心肌保护作用 苏醒质量 应激反应 |
| 英文关键词: Propofol Sevoflurane Anesthesia Congenital heart disease Interventional surgery Myocardial protection effect Awakening quality Stress response |
| 基金项目:江苏省妇幼保健协会基金项目（FYX20201123） |
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| 摘要 目的：研究丙泊酚联合七氟醚麻醉在先天性心脏病介入手术患儿中的心肌保护作用及对苏醒质量和应激反应的影响。方法：选择2020年1月~2022年4月期间在苏州大学附属儿童医院接受先天性心脏病介入手术患儿96例，按照双色球法将患儿分为对照组（n=48，接受瑞芬太尼、丙泊酚麻醉）和观察组（n=48，接受丙泊酚、七氟醚麻醉）。对比两组患儿心率、呼吸频率、平均动脉压、苏醒质量、心肌损伤指标、应激反应指标和不良反应发生率。结果：两组置喉罩时（T1）~拔除喉罩（T4）时间点心率、呼吸频率、平均动脉压下降后升高，观察组高于对照组同时间点（P<0.05）。观察组的苏醒时间、拔管时间均短于对照组（P<0.05）。两组术毕、术后24 h肌酸磷酸激酶同工酶（CK-MB）、心肌肌钙蛋白（cTnI）升高后下降，观察组低于对照组同时间点（P<0.05）。两组术毕、术后24 h血糖、皮质醇升高后下降，观察组低于对照组同时间点（P<0.05）。两组不良反应发生率组间对比，差异不显著（P>0.05）。结论：丙泊酚联合七氟醚麻醉应用于先天性心脏病介入手术中，可减轻患儿的应激反应，稳定机体血流动力学波动，同时还可发挥心肌保护作用，提高苏醒质量。 |
| 英文摘要: |
| ABSTRACT Objective: To study the myocardial protective effect of propofol combined with sevoflurane anesthesia in children undergoing interventional surgery for congenital heart disease and its effect on awakening quality and stress response. Methods: 96 children with congenital heart disease who underwent interventional surgery in Children's Hospital Affiliated to Soochow University from January 2020 to April 2022 were selected, and they were divided into control group (n=48, received remifentanil and propofol anesthesia) and observation group (n=48, received propofol and sevoflurane anesthesia) according to the two-color ball method. Heart rate, respiratory rate, mean arterial pressure, awakening quality, myocardial injury index, stress response index and incidence of adverse reactions were compared in the two groups. Results: The heart rate, respiratory rate and mean arterial pressure in the two groups at the time of laryngeal mask insertion (T1) and laryngeal mask removal (T4) decreased and then increased, the observation group was higher than the control group at the same time point (P<0.05). The awakening time and extubation time in the observation group were shorter than those in the control group (P<0.05). The creatine phosphokinase isoenzyme (CK-MB) and cardiac troponin I (cTnI) in the two groups at the end of the operation and 24 h after operation increased and decreased, the observation group was lower than the control group at the same time point (P<0.05). The blood glucose and cortisol in the two groups after operation and 24 h after operation increased and decreased, the observation group was lower than the control group at the same time point (P<0.05). There was no significant difference in the incidence of adverse reactions in the two groups (P>0.05). Conclusion: The application of propofol combined with sevoflurane anesthesia in interventional surgery for congenital heart disease can reduce the stress response of children, stabilize the fluctuation of body hemodynamics, and play the myocardial protective effect, improve the awakening quality. |
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