先天性心脏病应用七氟醚麻醉诱导的效果及对脑和心肌的保护作用

The Effect of Sevoflurane Anesthesia Induction in Congenital Heart Disease and Its Protection on Brain and Myocardium

目的探讨先天性心脏病应用七氟醚麻醉诱导的效果及对脑和心肌的保护作用。方法选择我院2013年11月—2016年11月收治的98例先天性心脏病患儿,按抽签法分为对照组与研究组,各49例。对照组采用氯胺酮麻醉诱导,研究组采用七氟醚麻醉诱导,比较两组麻醉效果,桡动脉血氧含量(CjvO_2)、桡动脉血氧饱和度(SjvO_2),磷酸肌酸激酶同工酶(CK-MB)、磷酸肌酸激酶(CK)、心肌肌钙蛋白I(cTnI)水平及并发症发生率。结果研究组苏醒时间、拔管时间优于对照组(P<0.05)。术前,两组CjvO_2、SjvO_2、CK-MB、CK、cTnI比较差异无统计学意义(P>0.05)。术后,两组CjvO_2、SjvO_2均降低,但研究组CjvO_2、SjvO_2高于对照组(P<0.05);两组CK-MB、CK、cTnI均上升,但研究组CK-MB、CK、cTnI低于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(14.29%与8.16%,P>0.05)。结论七氟醚麻醉诱导在先天性心脏病中的应用效果肯定,可对脑部及心肌起到保护作用。

Objective To investigate the effect of sevoflurane anesthesia induction in congenital heart disease and its protection on brain and myocardium. Methods Ninety-eight children with congenital heart disease from November 2013 to November 2016 were randomly divided into two groups：control group （ n=49） induced with ketamine,and research group （ n=49） induced with sevoflu-rane. The anesthesia effect,radial artery blood oxygen content （CjvO2） and radial artery blood oxygen saturation （SjvO2）,creatine ki-nase isoenzyme （CK-MB）,creatine phosphokinase （CK）,cardiac troponin I （cTnI）,and complications were compared. Results The wake up time,extubation time in research group were less than that in control group （ P〈0.05）. There was no difference in preopera-tive CjvO2,SjvO2,CK-MB,CK,cTnI between two group（P〉0.05）. The postoperative CjvO2,SjvO2 were reduced in two groups,which were higher in research group than that in control group （ P〈0.05）. The postoperative CK-MB,CK,cTnI were rised,which were lower in research group than that in control group （ P〈0.05）. There was no difference in the complications between two group （ P〉0.05）. Conclusion Sevoflurane anesthesia induction can protect the brain and myocardium in congenital heart disease.