右美托咪定复合七氟醚在小儿体表淋巴管畸形介入术中的应用研究

Application of dexmedetomidine combined with sevoflurane in interventional treatment of pediatric body surface lymphatic malformation

目的:探讨右美托咪定复合七氟醚在小儿体表淋巴管畸形介入术中的应用效果。方法:2017年5月-2020年5月收治体表淋巴管畸形患儿86例,均行介入硬化手术治疗;随机分为两组,各43例。对照组予以七氟醚复合丙泊酚麻醉;试验组予以右美托咪定复合七氟醚麻醉。比较两组麻醉效果。结果:试验组患儿基础麻醉时、插管后10 min平均动脉压(MAP)及心率(HR)水平显著低于对照组,差异有统计学意义(P<0.05)。试验组患儿术后24 h血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平均显著低于对照组,差异有统计学意义(P<0.05)。试验组患儿苏醒即刻、苏醒后30 min、60 min镇静(Ramsay)评分显著高于对照组,躁动(SAS)评分显著低于对照组,差异有统计学意义(P<0.05)。结论:右美托咪定复合七氟醚可稳定体表淋巴管畸形患儿硬化介入术中血流动力学,减轻机体炎症反应,减少术后躁动发生,镇静效果良好,是理想的麻醉方式。

Objective:To explore the application effect of dexmedetomidine combined with sevoflurane in interventional treatment of pediatric body surface lymphatic malformation.Methods:From May 2017 to May 2020,86 children with body surface lymphatic malformation were selected and treated with interventional sclerotherapy.They were randomly divided into two groups with 43 cases in each group.The control group was given sevoflurane combined with propofol anesthesia.The experimental group was given dexmedetomidine combined with sevoflurane anesthesia.We compared the anesthetic effect between the two groups.Results:In the experimental group,the mean arterial pressure(MAP)and heart rate(HR)during basic anesthesia and 10 minutes after intubation were significantly lower than those of the control group,the difference was statistically significant(P<0.05).In the experimental group,the serum levels of IL-6,IL-8 and TNF-αwere significantly lower than those in the control group at 24 hours after operation,the difference was statistically significant(P<0.05).In the experimental group,at the time of awaking,30 minutes and 60 minutes after awakening,the Ramsay score was significantly higher than that of the control group,and the SAS score was significantly lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with sevoflurane can stabilize hemodynamics during sclerotherapy of children with surface lymphatic malformation,reduce inflammatory reaction and reduce postoperative agitation,the effect of sedation is good and it is an ideal anesthesia method.