术前应用右美托咪定对学龄前儿童的有效性探讨(1)
【摘要】 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0.5 μg/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(mYPAS)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。
【关键词】 右美托咪定；儿童；学龄前；焦虑；应激反应
DOI：10.14163/j.cnki.11-5547/r.2016.08.001
Investigate of effectiveness by dexmedetomidine in preoperative application for preschool children LIU Gui-zhen， SUN Yu-chuan， LIU Fei. Shangdong Yantai City Laiyang Central Hospital， Yantai 265200， China
【Abstract】 Objective To investigate influence by preoperative application of dexmedetomidine on preoperative anxiety and stress hormone in preschool children. Methods A total of 100 preschool children receiving lower abdominal surgery were randomly divided into dexmedetomidine group (group D) and control group (group C)， with 50 cases in each group. Group D received 0.5 μg/kg of dexmedetomidine in 20 ml， and group C received normal saline through intravenous pumping within 20 min. Modified Yale preoperative anxiety scale (mYPAS) was applied to evaluate anxiety level before ward pumping (T1) and at the end of ward pumping (T2). Noradrenaline (NE)， epinephrine (E)， and cortisol (CS) were detected in blood sample taken at 1 d before operation and before anesthesia. Results There was no statistically significant difference of anxiety level at T1 between the two groups (P>0.05). Group D had much lower anxiety level than group C at T2， and the difference had statistical significance (P<0.01). Group C had obviously higher anxiety score at T2 than that at T1， the difference had statistical significance (P<0.05)， while the difference of anxiety score in group D had no statistical significance between T1 and T2 (P>0.05). There was no statistically significant difference of E， NE and CS levels at 1 d before operation between the two groups (P>0.05). Group C had much higher E， NE and CS levels before anesthesia than those at 1 d before operation， and the difference had statistical significance (P<0.01). There was no statistically significant difference in group D of E， NE and CS levels (P>0.05). Group D had obviously lower E， NE， CS levels than group C， and the difference had statistical significance (P<0.01). Conclusion Preoperative application of dexmedetomidine for intervention can reduce children anxiety， stress hormone secretion， and stress reaction., 百拇医药(刘桂祯?孙玉川?刘斐)
【关键词】 右美托咪定；儿童；学龄前；焦虑；应激反应
DOI：10.14163/j.cnki.11-5547/r.2016.08.001
Investigate of effectiveness by dexmedetomidine in preoperative application for preschool children LIU Gui-zhen， SUN Yu-chuan， LIU Fei. Shangdong Yantai City Laiyang Central Hospital， Yantai 265200， China
【Abstract】 Objective To investigate influence by preoperative application of dexmedetomidine on preoperative anxiety and stress hormone in preschool children. Methods A total of 100 preschool children receiving lower abdominal surgery were randomly divided into dexmedetomidine group (group D) and control group (group C)， with 50 cases in each group. Group D received 0.5 μg/kg of dexmedetomidine in 20 ml， and group C received normal saline through intravenous pumping within 20 min. Modified Yale preoperative anxiety scale (mYPAS) was applied to evaluate anxiety level before ward pumping (T1) and at the end of ward pumping (T2). Noradrenaline (NE)， epinephrine (E)， and cortisol (CS) were detected in blood sample taken at 1 d before operation and before anesthesia. Results There was no statistically significant difference of anxiety level at T1 between the two groups (P>0.05). Group D had much lower anxiety level than group C at T2， and the difference had statistical significance (P<0.01). Group C had obviously higher anxiety score at T2 than that at T1， the difference had statistical significance (P<0.05)， while the difference of anxiety score in group D had no statistical significance between T1 and T2 (P>0.05). There was no statistically significant difference of E， NE and CS levels at 1 d before operation between the two groups (P>0.05). Group C had much higher E， NE and CS levels before anesthesia than those at 1 d before operation， and the difference had statistical significance (P<0.01). There was no statistically significant difference in group D of E， NE and CS levels (P>0.05). Group D had obviously lower E， NE， CS levels than group C， and the difference had statistical significance (P<0.01). Conclusion Preoperative application of dexmedetomidine for intervention can reduce children anxiety， stress hormone secretion， and stress reaction., 百拇医药(刘桂祯?孙玉川?刘斐)