腭帆提肌重建术采用戊乙奎醚在治疗腭裂患儿中的临床效果及对炎性反应、氧化应激及血液动力学的影响

Clinical Effect of the Application of Penehyclidine in Levator Muscle of Palatine Velum Reconstruction in the Treatment of Cleft Palate and Its Influence on Inflammatory Reaction,Oxidative Stress and Hemodynamics

目的:探讨在腭帆提肌重建术中采用盐酸戊乙奎醚(PH)麻醉前用药对患儿身体功能的影响。方法:将2019年1月~2020年12月某院66例接受腭帆提肌重建术治疗的腭裂患儿随机分为研究组(34例)与对照组(32例),对照组术前给予阿托品,研究组给予PH。对比两组麻醉前、麻醉30min后血氧饱和度(SaO_(2))、动脉均压(MAP),两组手术前1d与手术后3d的一氧化氮(NO)、肿瘤坏死因子α(TNF-α)、丙二醛(MDA)、C反应蛋白(CRP)、超氧化物歧化酶(SOD)、降钙素原(PCT)水平。结果:两组诱导麻醉前SaO_(2)、MAP差异无统计学意义(P>0.05);麻醉后30min研究组SaO_(2)、MAP高于对照组,差异有统计学意义(P<0.05);手术前1d两组NO、SOD、MDA、CRP、TNF-α、PCT差异无统计学意义(P>0.05),手术后3d研究组SOD水平高于对照组(P<0.05),NO、MDA、CRP、TNF-α、PCT水平低于对照组(P<0.05)。结论:腭帆提肌重建术中采用PH麻醉前用药安全性较高,可有效减降低抗胆碱药物对患儿血液动力学的影响,减轻患儿围术期应激与炎症反应。

Objective:To investigate the effect of penehyclidine hydrochloride(PH)before anesthesia on the physical function of children with levator muscle of palatine velum reconstruction.Methods:From January 2019 to December 2020,76 children with levator muscle of palatine velum reconstruction in a hospital were randomly divided into study group(34 cases)and control group(32 cases).The control group was given atropine before operation,and the study group was given PH.The blood oxygen saturation(SaO_(2))and arterial pressure(MAP)before anesthesia and 30 minutes after anesthesia,and the nitric oxide(NO),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),C-reactive protein(CRP),superoxide dismutase(SOD),and the procalcitonin(PCT)levels 1d before surgery and 3d after surgery were compared between the two groups.Results:There was no significant difference in SaO_(2) and MAP between the two groups before anesthesia induction(P>0.05).At 30 minutes after anesthesia,SaO_(2) and MAP in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).One day before operation,there was no statistically significant difference in NO,SOD,MDA,CRP,TNF-α,and PCT between the two groups(P>0.05).The level of SOD in the study group was higher than that in the control group 3 days after operation(P<0.05),and the levels of NO,MDA,CRP,TNF-α,and PCT in the study group were lower than those in the control group(P<0.05).Conclusion:It is safe to use PH before anesthesia in levator muscle of palatine velum reconstruction,which can effectively reduce the effect of anticholinergic drugs on hemodynamics,and reduce perioperative stress and inflammatory reaction in children.