预注射盐酸戊乙奎醚对小儿全麻下腹腔镜腹股沟疝手术气道腺体分泌的影响

Effect of pre injection of penehyclidine hydrochloride on the airway gland secretion of children with laparoscopic inguinal hernia surgeryunder general anesthesia

目的 探讨预注射盐酸戊乙奎醚对小儿全麻下腹腔镜腹股沟疝手术气道腺体分泌的影响。方法 选取2013年11月~2016年1月宁波市北仑区中医院小儿外科择期接受全麻下腹腔镜腹股沟疝手术治疗的患儿72例,按随机数字表法分组,对照组36例术前预注射阿托品,研究组36例术前预注射盐酸戊乙奎醚,观测患儿预注射前（T0）、麻醉诱导前（T1）、诱导后5 min（T2）、诱导后10 min（T3）、拔管时（T4）的心率、气道腺体分泌情况、呼吸功能相关指标,同时对比不良反应的发生率。结果 与对照组比较,研究组术中气管导管重新固定率、T4时呛管发生率较低,复苏期吸痰次数、T4时吸痰时间较低,插管后5 min PIP、Raw水平较低,CL水平较高,T1、T2、T3、T4时刻HR水平较低,差异有统计学意义（P〈0.05）;研究组不良反应发生率30.56%低于对照组不良反应发生率11.11%,差异具有统计学意义（P〈0.05）。结论 预注射盐酸戊乙奎醚能抑制全麻下腹腔镜腹股沟疝手术患儿气道腺体分泌,保护呼吸功能,且不增加心率,安全性较高。

Objective To investigate the effect of pre injection of penehyclidine hydrochloride on the airway gland secretion of children with laparoscopic inguinal hernia surgery under general anesthesia. Methods 7 2 c a s e s of c h i l d r e n u n d e r g o i n g l a p a r o s c o p i c i n g u i n a l h e r n i a s u r g e r y u n d e r general anesthesia in pediatric surgery department in our hospital were selected and divided into two groups, grouped by random number table method, control group of 36 cases were treated with preoperative injection of atropine, the experiment group of 36 cases were treated with preoperative injection of penehyclidine hydrochloride. Heart rate on pre injection （ TO ） , before induction of anesthesia （ T1 ） , five min after induction （ T2 ） , ten min after induction （T3 ） and extubation （ T4 ） , the airway gland secretion, respiratory function related indexes, and the incidence of adverse reactions were compared. Results Compared with the control group, re fixed rate of tracheal tube during operation and the incidence of choking tube at T4 time were lower, the levels of PIP^Raw were lower and the level of CL was higher on five min after intubation, the HR at T1, T2 , T3, T 4 t i m e w a s l o w e r , w i t h statistical significance （ P 〈 0. 05 ） ;the incidence of adverse reactions in the control group 30. 56% was higher than the experiment group 11. 11% , with statistical significance （ P 〈 0. 05 ）. Conclusion P r e injection o f p e n e h y c l i d i n e h y d r o c h l o r i d e can inhibit a i r w a y g l a n d secretion in c h i l d r e n w i t h laparoscopic inguinal hernia surgery under general anesthesia, protect the respiratory function, and does not increase heart rate, the safety was higher.