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目的:探究不同浓度右美托咪啶对小儿麻醉后肌钙蛋白I、C反应蛋白以及补体变化的影响。方法:收集我院下腹股沟斜疝、急性阑尾炎以及肠套叠手术患儿75例,根据治疗方法不同分为三组,每组25例,其中A组实施0.5μg/kg负荷剂量右美托咪啶治疗,B组实施0.25μg/kg负荷剂量右美托咪啶治疗,C组实施右美托咪啶0.2~0.7μg/kg/h持续泵入。对比三组患者苏醒情况、血清肌钙蛋白I、C反应蛋白、补体水平、镇定及躁动评分。结果:手术后,B组自主呼吸恢复时间、气管导管拔管时间、解除监护时间明显缩短,且与其他两组比较,差异有统计学意义(P<0.05);与A、C两组相比,B组手术后C反应蛋白及血清肌钙蛋白I水平较低,而C3及C4水平较高,差异具有统计学意义(P<0.05);B组镇静、躁动评分明显降低,差异有统计学意义(P<0.05)。结论:0.25μg/kg负荷剂量右美托咪啶能够有效减轻患儿术后炎性反应,缓解麻醉后神经损伤,有助于脏器功能的恢复。
Objective: To investigate the effects of different concentrations of dexmedetomidine on changes of troponin I, C-reactive protein and complement after pediatric anesthesia. Methods: Totally 75 children with inguinal hernia, acute appendicitis and intussusception were enrolled in this study. The patients were divided into three groups (25 in each group). The patients in group A received a dose of dexamethasone Treatment with dexmedetomidine, dexmedetomidine (0.25μg / kg) and dexmedetomidine (0.2-0.7μg / kg / h) in Group C were continued. The recovery of three groups of patients was compared, serum troponin I, C-reactive protein, complement level, calming and agitation scores. Results: After operation, the recovery time of spontaneous resuscitation in group B, the time of extubation of tracheal tube, the time of relieving the guardianship were significantly shortened, and the difference was statistically significant (P <0.05) compared with the other two groups; compared with group A and C , While the levels of C-reactive protein and serum troponin I in group B were lower and the levels of C3 and C4 were higher in group B than those in group B (P <0.05); The scores of sedation and agitation in group B were significantly lower than those in group B Significance (P <0.05). Conclusion: Dexmedetomidine at a dose of 0.25 μg / kg can effectively relieve the postoperative inflammatory reaction, relieve the nerve injury after anesthesia, and help the recovery of organ function.