不同麻醉方式对血清金属硫蛋白、谷胱甘肽过氧化酶及患儿MMSE评分、MoCA评分的影响

Effects of different anesthesia methods on serum MTs,Gpx and MMSE scores and MoCA scores in children

目的探讨不同麻醉方式对血清金属硫蛋白(MTs)、谷胱甘肽过氧化酶(Gpx)及患儿MMSE评分、MoCA评分的影响。方法将2016年1月-2018年12月本院收治的116例气道异常患儿随机分为2组,2组患儿均进行气道异物取出术,观察组58例采用保留自主呼吸麻醉,而对照组58例采用控制呼吸麻醉。比较2组患儿生命体征变化、氧化应激状态、认知功能指标及并发症的差异。结果T1~T5时间点观察组患儿HR低于对照组,其MAP高于对照组(P<0.05);T3~T4时间点观察组患儿SpO2高于对照组(P<0.05),其余时间点2组患儿SpO2差异无统计学意义(P>0.05);手术后24 h、手术后48 h较手术前观察组患儿MMSE评分、MoCA评分降低,但其高于同期对照组(P<0.05);手术后24 h、手术后48 h较手术前观察组患儿MTs、Gpx水平升高,其也高于同期对照组(P<0.05);观察组患儿低氧血症发生率低于对照组(P<0.05),2组患儿在体位异动、喉痉挛、呛咳差异无统计学意义(P>0.05)。结论保留自主呼吸麻醉对气道异物取出术患儿临床效果佳,其有利于患儿稳定生命体征,有助于减轻氧化应激反应及认知功能损伤,不良反应也较少,值得临床选择。

Objective To investigate the effects of different anesthesia methods on serum MTs,Gpx and MMSE scores and MoCA scores in children.Methods A total of 116 children with airway abnormalities admitted to our hospital from January 2016 to December 2018 were randomly divided into two groups.Airway foreign body removal was performed in both groups.58 patients in the observation group were treated with retained spontaneous anesthesia,while 58 patients in the control group were treated with controlled breathing anesthesia.The differences in vital signs,oxidative stress,cognitive function indicators and complications between the two groups were compared.Results The HR of the observation group at T1-T5 time point was lower than that of the control group,and the MAP was higher than that of the control group(P<0.05).SpO2 in the observation group at T3-T4 time point was higher than that in the control group(P<0.05).There was no statistical significance on the difference in SpO2 between the two groups at the other time points(P>0.05).The MMSE score,MoCA score at 24 h after operation and 48 h after operation in the observation group were lower than that before operation,but it was higher than the control group at the same time(P<0.05).The levels of MTs,Gpx at 24 h after operation and 48 h after operation in the observation group were high than that before operation,it was higher than the control group at the same time(P<0.05).The incidence of hypoxemia in the observation group was lower than that in the control group(P<0.05).There was no statistical significance on the difference in postural movement,throat and cough between the two groups(P>0.05).Conclusion Retaining spontaneous breathing anesthesia has a good clinical effect on children with airway foreign body removal.It is beneficial to children with stable vital signs,which can help reduce oxidative stress and cognitive impairment,and has fewer adverse reactions,which is worthy of clinical selection.