中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (3): 244-247.doi: 10.19438/j.cjoms.2021.03.012

• 论著 • 上一篇    下一篇

不同麻醉维持药物对长时间手术婴幼儿血清同型半胱氨酸浓度的影响

仇琳, 李静洁, 张凌*, 蒋超*   

  1. 上海交通大学医学院附属第九人民医院 麻醉科,上海 200011
  • 收稿日期:2020-10-26 修回日期:2021-01-04 发布日期:2021-07-16
  • 通讯作者: 张凌,E-mail:zhangling_zl78@126.com;蒋超,E-mail: samsmail@163.com。*共同通信作者
  • 作者简介:仇琳（1978-）,女,硕士,主治医师,E-mail: jolin_ql@163.com

Effect of different anesthetic maintenance drugs on serum homocysteine concentration in infants undergoing long-term operation

QIU Lin, LI Jing-jie, ZHANG Ling, JIANG Chao   

  1. Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2020-10-26 Revised:2021-01-04 Published:2021-07-16

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摘要： 目的 比较丙泊酚全凭静脉、七氟烷全凭吸入及丙泊酚联合七氟烷静吸复合3种不同全麻维持药物对长时间手术婴幼儿血清同型半胱氨酸（Hcy）浓度的影响。方法 选择8~24月龄、手术时间>3 h的择期头颈颌面外科手术患儿51例,随机分为3组,即P组（丙泊酚全凭静脉维持）、S组(七氟烷全凭吸入维持）和C组(丙泊酚联合七氟烷静吸复合维持）,每组17例。所有患儿均行快速诱导经口腔气管内插管,术中根据麻醉深度监测、调整各组麻醉维持药物的用量。手术划皮前（T0）及手术结束即刻（T1）采集静脉血,测定血清Hcy浓度,比较各组术前、术后Hcy浓度及其变化。采用SPSS 21.0软件包对数据进行统计学分析。结果 与术前相比,术后3组患儿心率（HR）均显著下降（P<0.05）,无创血压（NIBP）、脉搏血氧饱和度（SPO2）无显著变化。与术前相比,C组患儿术后血清Hcy浓度显著下降（P<0.01）,S组、P组无显著变化。3组间术前、术后Hcy浓度及手术前、后Hcy变化值之间的差异均无统计学意义（P>0.05）。结论 七氟烷和丙泊酚单独或联合用于婴幼儿长时间手术麻醉维持,对血清Hcy浓度影响都较小。

关键词: 婴幼儿, 七氟烷, 丙泊酚, 同型半胱氨酸, 长时间手术

Abstract: PURPOSE: To compare the effect of three different general anesthetic maintenance drugs: propofol intravenous, sevoflurane inhalation and propofol intravenous injection combined with sevoflurane in halation, on serum homocysteine (Hcy) concentration in infants undergoing long-term operation. METHODS: Fifty-one children aged 8-24 months with operation time more than 3 hours were randomly divided into three groups: group P（propofol intravenous injection), group S（sevoflurane inhalation) and group C（propofol intravenous injection combined with sevoflurane inhalation).All the infants underwent rapid induction transoral endotracheal intubation, and the dosage of anesthesia maintenance drugs in each group was adjusted according to the depth of anesthesia during operation. Venous blood was collected at the beginning of the operation (T0) and immediately after the end of the operation (T1), to determine the serum hcyconcentration(Hcy). Preoperative and postoperative Hcy concentrations and their changes in each group were compared. Statistical analysis was performed using SPSS 21.0 software package. RESULTS: Compared with the preoperative period, HR of the infants in all three groups were significantly decreased (P<0.05), but there was no significant difference in NIBP and SpO2.Compared with preoperative level, serum Hcy concentration of group C decreased significantly after operation(P<0.01), while there was no significant difference between group S and group P. There was no significant difference between the three groups in Hcy concentration at T0 and T1(P>0.05). CONCLUSIONS: Propofol and sevoflurane alone or combined with anesthesia maintenance in infants with long-term operation has little effect on serum Hcy concentration.

Key words: Infant, Sevoflurane, Propofol, Homocysteine, Long-term operation

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