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目的观察右美托咪定(DEX)泵注用于腹腔镜疝囊高位结扎术时对患儿苏醒期躁动及血流动力学的影响。方法将47例行腹腔镜疝囊高位结扎术患儿根据数字表法随机分为A组22例和B组25例,2组患儿均采取七氟烷及瑞芬太尼静吸复合气管插管全身麻醉,B组在此基础上复合静脉泵注DEX。比较2组患儿各时间点血流动力学指标变化及苏醒状况。结果 B组患儿PAED评分、拔管时呛咳反应评分及苏醒期躁动发生率均明显低于A组,差异均有统计学意义(P<0.05)。2组患儿的拔管时间、睁眼时间及PACU停留时间比较差异均无统计学意义(P>0.05)。2组T0、T_1、T_2时点的HR、MAP水平比较差异无统计学意义(P>0.05)。B组患儿T_3、T_4、T_5时的HR、MAP等血流动力学指标均明显低于A组,差异均有统计学意义(P<0.05)。结论 DEX泵注可明显降低腹腔镜疝囊高位结扎术患儿苏醒期躁动发生率,并保持血流动力学处于稳定状态。
Objective To observe the effects of dexmedetomidine (DEX) pump on the recovery of agitation and hemodynamics in children with high ligation of laparoscopic hernia sac. Methods Totally 47 children undergoing laparoscopic high ligation of hernia sac were randomly divided into group A (n = 22) and group B (n = 25). According to the digital table method, sevoflurane and remifentanil Tube general anesthesia, B group on the basis of composite intravenous injection of DEX. The changes of hemodynamics and wakefulness in each group were compared between two groups. Results The PAED score, choking reaction score during extubation and the rate of restlessness during recovery were significantly lower in group B than those in group A (P <0.05). There was no significant difference in the extubation time, open-eye time and PACU stay between the two groups (P> 0.05). There were no significant differences in HR and MAP between the two groups at T0, T_1 and T_2 (P> 0.05). The hemodynamics indexes of HR, MAP and other indexes of T_3, T_4 and T_5 in group B were significantly lower than those in group A (P <0.05). Conclusion DEX pump can significantly reduce the incidence of agitation in the recovery period of patients with high ligation of laparoscopic hernia sac, and keep the hemodynamics stable.