右美托咪定复合氯胺酮对经介入手术治疗的先天性心脏病患儿心肌功能、血流动力学的影响

Effects of Dexmedetomidine Combined with Ketamine on Myocardial Function and Hemodynamics in Children with Congenital Heart Disease Treated by Interventional Surgery

目的探讨右美托咪定复合氯胺酮对经介入手术治疗的先天性心脏病患儿心肌功能、血流动力学的影响。方法回顾性选取2019年1月—2023年1月锡林郭勒盟中心医院收治的47例先天性心脏病患儿的临床资料,以随机数表法分成两组,对照组23例采用氯胺酮麻醉,观察组24例采用右美托咪定复合氯胺酮麻醉。均观察至术后12 h。比较两组麻醉情况、血流动力学及心肌功能指标。结果观察组氯胺酮用量少于对照组,差异有统计学意义(P<0.05);观察组苏醒时间短于对照组,差异有统计学意义(P<0.05);观察组T1、T2、T3的心率和平均动脉压分别为(108.25±5.26)次/min、(102.75±5.15)次/min、(91.84±5.10)次/min、(96.47±7.48)mmHg、(90.36±6.35)mmHg、(81.47±6.23)mmHg,均低于对照组,差异有统计学意义(t=5.568、3.187、3.642、3.633、4.469、2.856,P<0.05);观察组术后6 h、术后12 h血清心脏型脂肪酸结合蛋白、血清肌酸激酶同工酶、肌酸激酶水平低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合氯胺酮可有效稳定经介入手术治疗的先天性心脏病患儿血流动力学,减轻心肌损伤,麻醉效果较好。

Objective To investigate the effects of dexmedetomidine combined with ketamine on myocardial function and hemodynamics in children with congenital heart disease treated by interventional surgery.Methods The clinical data of 47 children with congenital heart disease admitted to Xilingol League Central Hospital from January 2019 to January 2023 were retrospectively selected and divided into two groups according to the random number table method.The control group(n=23)was given ketamine anesthesia,and the observation group(n=24)was given dexmedetomi⁃dine combined with ketamine anesthesia.All patients were observed until 12 h after operation.Compare two groups of anesthesia,hemodynamics and myocardial function index.Results The dosage of ketamine in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).The recovery time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).In the observation group,the heart rate and mean arterial pressure at T1,T2 and T3 were(108.25±5.26)times/min,(102.75±5.15)times/min,(91.84±5.10)times/min,(96.47±7.48)mmHg,(90.36±6.35)mmHg and(81.47±6.23 mmHg),lower than the control group,the difference was statistically significant(t=5.568,3.187,3.642,3.633,4.469,2.856,P<0.05);The levels of serum heart-type fatty acid binding protein,serum creatine kinase isoenzyme and cre⁃atine kinase in the observation group were lower than those in the control group 6 h and 12 h after operation,and the differences were statistically significant(P<0.05).Conclusion Dexmedetomidine combined with ketamine can effec⁃tively stabilize the hemodynamics of children with congenital heart disease treated by interventional surgery,reduce myocardial injury,and have a good anesthetic effect.