盐酸戊乙奎醚用于新生儿肠梗阻急诊手术的临床观察

Effect of penehyclidine in emergency neonate ileus surgery

目的观察盐酸戊乙奎醚在新生儿肠梗阻急诊手术中对误吸所致肺部症状的影响。方法急诊肠梗阻手术新生儿40例,术前均因误吸导致肺部炎症,随机均分为盐酸戊乙奎醚组(A组)和阿托品组(B组)。麻醉诱导前A组静注盐酸戊乙奎醚0.3 mg,B组静注阿托品0.1 mg。听诊患儿给药前及给药后10 min的呼吸音;记录给药前、给药后10、30 min鼓膜温度、HR、SpO2;观察给药前、给药后30 min及术毕患儿面色和口腔分泌物情况;记录拔管时间及ICU停留时间。结果给药后10 min,A组肺部干湿啰音消失或减轻,B组无明显改变。给药后10、30 min,A组HR慢于、鼓膜温度低于、SpO2高于B组(P<0.05)。A组在ICU停留时间明显短于B组(P<0.05)。结论盐酸戊乙奎醚用于新生儿肠梗阻急诊手术可减轻患儿误吸所致的肺部症状,改善患儿末梢循环,缩短患儿在ICU停留时间。

Objective To observe the effect of penehyclidine hydrochloride in emergency neonate ileus surgery with aspiration-induced sympotom of lung. Methods Forty neonates suffered from ileus were equally randomized into penehyclidine group（A group）and atropine group （B group）. Neonates intravenously received pnehyclidine hydrochloride 0.3 mg in A group and atropine 0.1 mg in B group before anesthesia induction. Breath sound was auscultated before and 10 rain after administration; temperature of eardrum, HR and SpO2 were recorded before and 10 min, 30 min after administration; complexion and oropharyngeal secretion were observed before administration, 30 min after administration and at the end of operation; and time of extubation and duration in intensive care unit （ICU） were also recorded. Results Ten minutes after administration, rhonchus and moist rales disappared or reduced in A group while no significant change in B group. Ten minutes and 30 rain after administration, A group had slower HR, lower temperature of eardrum and higher SpO2 than B group （P〈0.05）. The duration in ICU was shorter in A group than B group （ P 〈 0. 05 ）. Conclusion Pnehyclidine hydrochloride can ameliorate aspiration-induced sympotom of lung, improve peripheral circulation and shorten the duration in ICU.