氯胺酮对法鲁氏四联症心肌酶影响的研究

Influence of Ketamine inducdtion on Myocardial Enzymes in Corrective Surgery for Tetralogy of Fallot

目的:研究以氯胺酮与芬太尼行麻醉诱导对法鲁氏四联症患儿心肌酶的影响。方法:选择择期法鲁氏四联症矫治术患儿68例,采用双盲法随机分为实验组与对照组,每组34例。实验组诱导时依次静注氯胺酮1mg/kg,安定0.2mg/kg,阿曲库胺0.6mg/kg。对照组诱导给予芬太尼0.1mg,安定0.2mg/kg,阿曲库胺0.6mg/kg。术中管理采用相同原则。两组均在术的、术后8h、24h、48h抽取静脉血,测定血清谷草转氨酶(AST)、血清乳酸脱氢酶(LDH)和血清骨肌酶激酶的同工酶(CKMB)的变化。结果:实验组与对照组心肌酶变化:术前AST、LDH、CKMB均无明显改变,而实验组术后8h、24h及48h血清AST、LDH、CKMB的增加幅度明显低于对照组,两组间有显著差异(P<0.01)。结论:氯胺酮用于麻醉诱导能够降低法鲁氏四联症患儿术后AST、LDH、CKMB的增加,是较理想的药物及麻醉方法。

Objective： To study the influence of ketamine and fentanyl induedtion on myocardial enzymes in children undergoing corrective surgery for tetralogy of Fallot. Methods ： 68 children undergoing corrective surgery for tetralogy of Fallot were assigned randomly in two groups, experimental and control group, there were 34 in each group. Induedtion ： ketamine 1 mg/kg, diazepam O. 2mg/kg, atracurium 0.6mg/kg in experimental group ;fantanyl 0. lmg,diazepam 0.2mg/kg, atraeurium 0.6mg/kg in control group. Vein blood was collected before the surgery and 8h, 24h,48h after the surgery for AST LDH and CKMB test. Results： there were no difference of AST,LDH and CKMB in two groups before the surgery,and there were significant difference of AST, LDH aud CKMB at 8h,24h and 48h after the surgery,and the increase of AST, LDH and CKMB were lower in experimental group comparing with those in control group （P 〈 0. 01 ）. Conclusions： Ketamine inducdtion can abate the increase of AST,LDH and CKMB after the corrective surgery for tetralogy, of Fallot as a perfect anesthetics.