金莲花软胶囊联合右美托咪定用于儿童扁桃体腺样体切除术后镇痛效果及对炎性因子、血流动力学的影响

Effect of Jinlianhua Soft Capsule(金莲花软胶囊) Combined with Dexmedetomidine on Postoperative Analgesia,Inflammatory Factors and Hemodynamics in Children with Tonsillectomy

目的 探讨金莲花软胶囊联合右美托咪定用于儿童扁桃体腺样体切除术后镇痛效果及对炎性因子、血流动力学的影响。方法 选取医院收治的扁桃体腺样体切除术患儿83例,随机分为对照组(42例)和研究组(41例)。对照组术后给予右美托咪定,研究组在对照组基础上给予金莲花软胶囊,两组患儿均持续治疗72 h。对比两组患儿术后镇痛前(T_(0))、术后镇痛24 h (T_(1))、术后镇痛48 h (T_(2))、术后镇痛镇痛72 h(T_(3))的CHEOPS评分和Ramsay镇静评分、躁动评分、血清IL-6、TNF-α和CRP水平、MAP和HR值及不良反应情况。结果 研究组躁动发生率、苏醒时间、术后拔管时间和解除监护时间低于对照组,差异无统计学意义(P>0.05);在T_(0)和T_(1)时刻两组患儿CHEOPS评分差异无统计学意义(P>0.05);在T_(2)和T_(3)时刻研究组患儿CHEOPS评分明显低于对照组(P<0.05);在T_(0)和T_(1)时刻两组Ramsay镇静评分差异无统计学意义(P>0.05);在T_(2)和T_(3)时刻研究组患儿Ramsay镇静评分明显低于对照组(P<0.05);两组T_(0)和T_(1)时刻血清IL-6、TNF-α和CRP水平差异无统计学意义(P>0.05);两组T_(2)和T_(3)时刻研究组血清IL-6、TNF-α和CRP水平显著低于对照组(P<0.05);两组T_(0)和T_(1)时刻MAP和HR值差异无统计学意义(P>0.05);两组T_(2)和T_(3)时刻研究组MAP和HR值显著优于对照组(P<0.05);在T_(0)、T_(1)和T_(2)时刻两组患儿躁动评分差异无统计学意义(P>0.05);在T_(3)时刻研究组患儿躁动评分明显低于对照组(P<0.05)。结论 扁桃体腺样体切除术后患儿采用金莲花软胶囊联合右美托咪定进行治疗,具有较好的镇痛疗效,可改善炎性因子和血流动力学水平,值得在临床上推广应用。

Objective To investigate the analgesic effect of Jinlianhua Soft Capsule(金莲花软胶囊) combined with dexmedetomidine on children after tonsillectomy and the effects on inflammatory factors and hemodynamics.Methods A total of 83 children with adenoidectomy of tonsils were selected and randomly divided into control group(42 cases) and study group(41 cases).The control group was given dexmedetomidine after surgery,and the study group was given Jinlianhua Soft Capsule on the basis of the control group.Both groups were treated for 72 h.The Cheops score and Ramsay sedation score,the score of agitation,serum levels of interleukin 6(IL-6),tumor necrosis factor α(TNF-α) and C-reactive protein(CRP),values of mean arterial pressure(MAP) and heart rate(HR) and adverse reactions were compared between the two groups before postoperative analgesia(T_(0)),24 h after postoperative analgesia(T_(1)),48 h after postoperative analgesia(T_(2)) and 72 h after postoperative analgesia(T_(3)).Results The incidence of agitation,recovery time,postoperative extubation time and discharge time in the study group were lower than those in the control group,and the differences were not statistically significant(P>0.05).There was no difference in Cheops score between the two groups at T_(0) and T_(1)(P>0.05).The Cheops score in the study group was significantly lower than that in the control group at T_(2) and T_(3)(P0.05).Ramsay sedation score in the study group was significantly lower than that in the control group at T_(2 )and T_(3)(P0.05).The levels of serum IL-6,TNF-α and CRP in the study group were significantly lower than those in the control group at T_(2) and T_(3)(P0.05).The values of MAP and HR in the study group were significantly better than those in the control group at T_(2) and T_(3)(P0.05).The score of agitation in the study group was significantly lower than that in the control group at T_(3)(P<0.05).Conclusions Jinlianhua Soft Capsule combined with dexmedetomidine in the treatment of children after tonsillectomy has a good analgesic effect and can improve the levels of inflammatory factors and hemodynamics,which is worthy of clinical application.