术前预注右美托咪定在小儿腹股沟斜疝手术中的应用效果

doi:10.3969/j.issn.1671-7171.2023.04.014

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摘要【目的】探讨右美托咪定术前用药对行腹股沟斜疝疝囊高位结扎术患儿的可行性与安全性。【方法】选择2020年7月至2021年8月在本院行腹股沟斜疝疝囊高位结扎术治疗的90例腹股沟斜疝患儿,根据随机数字表法将其分为观察组和对照组,每组45例。两组均采用静吸复合全身麻醉,观察组为右美托咪定术前用药组,对照组于麻醉诱导前静脉泵入生理盐水。观察两组患儿术前焦虑、术中血流动力学变化、术后疼痛及术后不良反应的发生率。【结果】观察组患儿入手术室时后5 min(T₁)、置入喉罩后5 min(T₂)、手术开始后5 min(T₃)、拔出喉罩后5 min(T₄)、入麻醉恢复室后5 min(T₅)时的SBP、DBP均低于对照组,差异有统计学意义(P<0.05)。观察组患儿T₁、T₂、T₃、T₄、T₅、出恢复室时的HR均低于对照组,差异有统计学意义(P<0.05)。观察组患者入手术室、麻醉诱导时、术后24 h时的耶鲁术前焦虑量表(m-YPAS)评分低于对照组,差异有统计学意义(P<0.05)。观察组术后1 d、术后2 d时的疼痛评分低于对照组,差异有统计学意义(P<0.05);观察组Ramsay评分低于对照组,差异有统计学意义(P<0.05)。两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】术前预注右美托咪定应用于行腹股沟斜疝疝囊高位结扎术中,可缓解患儿围术期焦虑情绪,减轻术后疼痛,降低了术后躁动的发生率,且未见明显的不良反应。

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关键词 ：疝,腹股沟/外科学, 结扎术/方法, 右美托咪啶/药理学, 儿童

Abstract：【Objective】 To explore the feasibility and safety of preoperative medication of dexmedetomidine in children undergoing high ligation of inguinal hernia sac. 【Methods】 A total of 90 children with indirect inguinal hernia who underwent high ligation of inguinal hernia sac in our hospital from July 2020 to August 2021 were selected and randomly divided into an observation group and a control group,with 45 cases in each group. Both groups were treated with intravenous inhalation combined with general anesthesia. The observation group was treated with dexmedetomidine before surgery,while the control group received intravenous infusion of physiological saline before anesthesia induction. The incidence of preoperative anxiety,intraoperative hemodynamic changes,postoperative pain,and postoperative adverse reactions in both groups of children were observed. 【Results】 The SBP and DBP of the observation group were lower than those of the control group at 5 minutes after entering the operating room (T₁),5 minutes after inserting the laryngeal mask (T₂),5 minutes after starting the surgery (T₃),5 minutes after removing the laryngeal mask (T₄),and 5 minutes after entering the anesthesia recovery room (T₅),with statistically significant differences (P<0.05). The T₁,T₂,T₃,T₄,T₅,and HR of the observation group were lower than those of the control group when leaving the recovery room,and the difference was statistically significant (P<0.05). The m-YPAS scores of patients in the observation group were lower than those in the control group during admission to the operating room,anesthesia induction,and 24 hours after surgery,with a statistically significant difference (P<0.05). The pain scores of the observation group at 1 day and 2 days after surgery were lower than those of the control group,and the difference was statistically significant (P<0.05); The Ramsay score of the observation group was lower than that of the control group,and the difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups of children (P>0.05). 【Conclusion】 Preinjection of dexmedetomidine before surgery should be used for high ligation of inguinal hernia sac,which can alleviate perioperative anxiety,alleviate postoperative pain,reduce the incidence of postoperative restlessness,and have no obvious adverse reactions.

Key words： Hernia,Inguinal/SU Ligation/MT Dexmedetomidine/PD Child

收稿日期: 2023-02-27

中图分类号:

R726.562.1

基金资助:湖南省自然科学基金项目(S2019JJQNJJ0583)

通讯作者: ** E-mail:meggyzhen@163.com

引用本文:

向珍, 危思维, 禹二友, 陈政, 杜真. 术前预注右美托咪定在小儿腹股沟斜疝手术中的应用效果[J]. 医学临床研究, 2023, 40(4): 531-534.
XIANG Zhen, WEI Si-wei, YU Er-you, et al. Application Effect of Preoperative Dexmedetomidine Injection in Pediatric Inguinal Hernia Surgery. JOURNAL OF CLINICAL RESEARCH, 2023, 40(4): 531-534.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.04.014 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I4/531

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