ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2016, Vol. 8 ›› Issue (2): 154-157.doi: 10.3969/j.issn.1674-3865.2016.02.009

• 临床研究 • 上一篇    下一篇

静吸复合麻醉联合骶管阻滞对新生儿心肾功能的影响

谢秋媚   

  1. 516001广东 惠州，惠州市中心人民医院麻醉科
  • 出版日期:2016-04-25 发布日期:2018-11-19
  • 作者简介:谢秋媚(1982-)，女，主治医师。研究方向：新生儿麻醉

Effect of intravenous anesthesia combined with sacral canal block on cardiac and renal function of neonates

XIE Qiumei   

  1. People′s Center Hospital of Huizhou,Huizhou 516001,China.
  • Online:2016-04-25 Published:2018-11-19

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摘要：
目的：分析静吸复合麻醉联合骶管阻滞在新生儿手术中对患儿心脏、肾脏功能的影响。
方法：选择2013年6月至2014年12月在惠州市中心人民医院接受手术治疗的新生儿80例为研究对象，随机分为观察组与对照组各40例。对照组行单纯静吸复合麻醉，观察组行静吸复合麻醉联合骶管阻滞，对比两组患儿术中、术后的各项心、肾功能指标的变化情况。
结果：(1)术前，两组患儿的各项心功能指标比较差异均无统计学意义(P>005)；术中，对照组患儿的心率、中心静脉压、收缩压、舒张压、心排血指数及Tei指数均出现显著性升高，差异有统计学意义(P<005)；停药后又呈下降趋势，但除Tei指数外，其余指标仍旧高于术前水平，差异有统计学意义(P<005)。观察组患儿在术中仅中心静脉压、Tei指数出现升高，但在停药后均恢复至术前水平；其余术中指标与术前比较差异均无统计学意义(P>005)，且显著低于对照组的术中指标，差异有统计学意义(P<005)。(2)术前，两组患儿各项肾功能指标比较差异无统计学意义(P>005)；术中，两组患儿的肌酐、尿素氮、N-乙酰-Β-D-氨基葡萄糖苷酶、视黄醇结合蛋白均显著高于术前，差异有统计学意义(P<005)，但观察组升高幅度低于对照组，差异有统计学意义(P<005)；停药后，观察组均可恢复至术前水平，而对照组的肌酐、N-乙酰-Β-D-氨基葡萄糖苷酶、视黄醇结合蛋白尚无法立即恢复至术前水平，差异有统计学意义(P<005)。(3)观察组术后的自主呼吸恢复时间、苏醒时间、清醒时间及拔管时间均明显低于对照组，差异有统计学意义(P<001)，警觉/镇静评分高于对照组，差异有统计学意义(P<005)；观察组术中无患儿出现躁动表现，对照组有8例患儿出现躁动不安的行为，两组比较差异有统计学意义(P<001)。
结论：静吸复合麻醉联合骶管阻滞具有理想的麻醉效果，可有效降低新生儿心脏的应激反应，对肾脏无明显影响。

关键词: 骶管阻滞, 静吸复合麻醉, 心肾功能, 婴儿, 新生

Abstract:
Objective:To analyze the effect of intravenous anesthesia combined with sacral canal block on the heart and kidney function in neonates.
Methods:A total of 80 infants who received surgical treatment in our hospital from June 2013 to December 2014 were chosen as the research objects,and were assigned to the control group and the experiment group(with 40 in each).In the experiment group,the patients were treated with intravenous anesthesia combined with sacral canal block,and the control group was treated with intravenous inhalation anesthesia.The changes of cardiac and renal function were compared between the two groups.
Results:(1)There was no significant difference in preoperative heart function index between the two groups(P>005).During the surgery,CVP,SBP,Tei,CIL,DBP and HR of the control group were significantly higher,which decreased after the surgery but remained higher than the preoperative level except Tei index(P<005).(2)There were no significant differences in renal function index(P>005)in the two groups before treatment,while during the surgery the Scr,NAG,BUN and RBP were significantly higher in the two groups(P<005),but the increase was lower in the experiment group than that in the control group(P<005).The NAG,RBP and Scr in the control group were not immediately restored after treatment(P<005).(3)The postoperative spontaneous breathing recovery time,waking time,awake time and extubation time in experiment group were significantly shorter than in control group(P<001),OAA/S score higher than the control group(P<005).There were no children with restlessness in experiment group,while there were 8 cases(40%)in the control group(P<001).
Conclusion:Intravenous anesthesia combined with sacral canal block has an ideal anesthetic effect,which can reduce the stress reaction of heart in neonates while shows no significant effect on kidney.

Key words: Sacral canal block, Intravenous anesthesia, Heart and kidney function, Neonate