家长陪同诱导对拔除输尿管支架幼儿应激因子的影响

Influence of parents accompanying induction on the kids’stress-related mediators during recovery

目的探讨家长陪同诱导对拔除输尿管支架幼儿苏醒期应激相关因子的影响。方法101例2019年8月至2020年12月郑州大学第一附属医院河医院区门诊泌尿内镜室拔除输尿管支架的幼儿分为家长陪同诱导组P组(n=51)和医护诱导组N组(n=50),记录幼儿入睡时间和血氧饱和度(SpO2)<90%的发生率,拔除输尿管支架后即刻抽血检测静脉血糖浓度,并酶联免疫吸附试验(ELISA)检测血清中皮质醇(COR)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)浓度。结果P组SpO2<90%的发生率远高于N组(19.6%比6.0%,P<0.05);N组入睡时间的均值高于P组[(24.9±5.0)min比(17.1±2.7)min,P<0.05];两组幼儿苏醒期静脉血糖[(4.9±0.8)mmol/L比(4.7±0.9)mmol/L,P>0.05]差异无统计学意义;COR、AngⅡ和NE血清浓度的均值N组均高于P组[(211.5±17.1)nmol/ml比(170.3±22.9)nmol/ml、(17.8±3.8)pg/ml比(12.9±2.9)pg/ml和(93.6±6.9)mmol/L比(72.1±10.1)mmol/L,P<0.05]。结论幼儿家长陪同镇静诱导降低拔除输尿管支架幼儿机体苏醒期应激相关因子的水平。

Objective To investigate the influence of parents accompanying kids induction on the stress-related factors during recovery.Methods A total of 101 kids from the endoscopy department in outpatient of the first affiliated hospital of zhengzhou university refusing to cooperate with removal of ureter stent were divided into group P accompanied by parents and group N accompanied by anesthesia nurses.Data were collected as follows:sleep entry time during sedation induction,the venous concentration of blood glucose,cortisol,angiotensinⅡand noradrenaline.The data were analyzed by SPSS 22.0.Results The incidence rate of SpO2<90%was higher in group P than in group N(19.6 vs.6.0%,P<0.05).The sleep entry time in group N was longer than in group P[(24.9±5.0)min vs.(17.1±2.7)min,P<0.05].The serum concentration of cortisol,angiotensinⅡand noradrenaline during recovery in group N were all higher than in group P[(211.5±17.1)nmol/ml vs.(170.3±22.9)nmol/ml,(17.8±3.8)pg/ml vs.(12.9±2.9)pg/ml and(93.6±6.9)mmol/L vs.(72.1±10.1)mmol/L,P<0.05],but there was no significant difference in venous blood glucose concentration between two groups[(4.9±0.8)mmol/L vs.(4.7±0.9)mmol/L,P>0.05].Conclusion Parents accompanying induction reduces kids’stress-related mediators during recovery.