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目的探讨术前应用右美托咪定对学龄前儿童术前焦虑和应激激素的影响。方法择期行下腹部手术的学龄前患儿100例,随机分右美托咪定组(D组)和对照组(C组),各50例,D组右美托咪定0.5μg/kg稀释到20 ml,C组为等量生理盐水,单次静脉微量泵注,20 min内泵注完毕。在病房泵注前(T1)、病房泵注结束(T2)2个时间点,以改良耶鲁围术期焦虑量表(m YPAS)评估焦虑水平;所有患儿于术前1 d同一时刻和麻醉前取血测去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(CS)。结果两组患儿在T1时刻焦虑程度差异无统计学意义(P>0.05);D组患儿在T2时刻的焦虑评分明显低于C组,差异具有统计学意义(P<0.01)。C组患儿焦虑评分T2时刻明显高于T1,差异有统计学意义(P<0.05),D组患儿T1、T2时刻焦虑评分差异无统计学意义(P>0.05)。两组患儿术前1 d所测E、NE、CS差异无统计学意义(P>0.05)。C组麻醉前E、NE、CS明显高于术前1 d,差异具有统计学意义(P<0.01),D组麻醉前E、NE、CS与术前1 d比较差异无统计学意义(P>0.05);组间比较,D组麻醉前所测E、NE、CS明显低于C组,差异有统计学意义(P<0.01)。结论术前应用右美托咪定干预,可消除患儿焦虑,减少应激激素分泌,减轻其应激反应。
Objective To investigate the effect of preoperative application of dexmedetomidine on preoperative anxiety and stress hormone in preschool children. Methods A total of 100 preschool children undergoing abdominal surgery were randomly divided into 2 groups: dexmedetomidine (group D) and control group (group C), 50 patients in each group. Group D received dexmedetomidine 0.5 μg / kg To 20 ml, group C was the same amount of saline, a single intravenous micro-pump injection, pump injection within 20 min is completed. The anxiety level was evaluated by m YPAS in the ward before injection (T1) and ward injection (T2) at 2 time points. All patients were anesthetized at the same time before d Before taking blood test norepinephrine (NE), epinephrine (E), cortisol (CS). Results There was no significant difference in the level of anxiety between the two groups at T1 (P> 0.05). The score of anxiety at T2 was significantly lower in group D than that in group C (P <0.01). The scores of anxiety score in group C were significantly higher than those in T1 at T2 (P <0.05). There was no significant difference in anxiety score at T1 and T2 among children in group C (P> 0.05). There was no significant difference in E, NE and CS between the two groups before operation (P> 0.05). The values of E, NE, CS in group C before anesthesia were significantly higher than those in preoperative day 1 (P <0.01), and there was no significant difference in the values of E, > 0.05). Compared between groups, the levels of E, NE and CS measured before anesthesia in group D were significantly lower than those in group C, the difference was statistically significant (P <0.01). Conclusion Preoperative application of dexmedetomidine intervention can eliminate anxiety in children, reduce the secretion of stress hormones and reduce their stress response.