右美托咪定在小儿肝脏手术中的应用效果

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Abstract Objective To investigate the application effect of dexmedetomidine in pediatric liver surgery. Methods A total of 60 children who underwent liver lumpectomy at Hu’nan Children’s Hospital from July 2018 to June 2020 were selected. According to random number table method, they were divided into group D and group P, with 30 patients in each group. Group D was treated with Dexmedetomidine, and group P was treated with Propofol. The level of hemodynamic indexes, regional cerebral oxygen saturation (rSCO2) and serum contents of brain-derived neurotrophic factor (BDNF), S-100β, interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) and superoxide dismutase (SOD) were compared between the two groups. Results There were statistically significant differences in heart rate (HR) between the two groups and mean arterial pressure (MAP) of group D at each time point (all P ＜ 0.05). The differences of the MAP at T1, T2, T3, T4 time points in group P compared with T0, with the statistically significant (all P ＜ 0.05). The HR of group D at T1, T2, T3, T4 time points were lower than those of group P at the same time point, the MAP of group D at T2, T3, T4 time points were lower than those of group P at the same time point, SpO2 in group D were higher than those in group P at T2, T3 time points, and the differences were statistically significant (all P ＜ 0.05). LrSCO2 in group D at time point T1 was higher than that at T0, and at time point T3 was lower than that at T1, LrSCO2 in group P at time points T2 and T3 were lower than those at T0 and T1, and at time point T4 was higher than that at T3, the differences were statistically significant (all P ＜ 0.05). RrSCO2 in group D at time point T1 was higher than that at T0, and at time point T2, T3 were lower than those at time point T1, RrSCO2 in group P at time points T2 and T3 were lower than those at T0 and T1, and at time point T4 was higher than that at T2, T3, the differences were statistically significant(all P ＜ 0.05). The LrSCO2 and RrSCO2 of group D at time points T1, T2 and T3 were higher than those of group P at the same time points, and the differences were statistically significant (all P ＜ 0.05). There were statistically significant differences in BDNF levels between the two groups at each time point (all P ＜ 0.05). There were no significant differences in S-100β level at T2 and T3, T3 and T4 time points in group D (P ＞ 0.05), but there were significant differences at other time points in group D (P ＜ 0.05). The levels of S-100β in group P at time points T2, T3, T4 were higher than those at time point T0, T1, and at time point T4 was higher than that at time points T2, T3, with statistical significance (all P ＜ 0.05). The levels of BDNF at T2, T3, T4 in group D were higher than those in group P at the same time point, and the levels of S-100β were lower than those in group P at the same time points, with statistical significance (all P ＜ 0.05). There were significant differences in the time points of IL-10, TNF-α and SOD between the two groups (all P ＜ 0.05). The levels of IL-10 at time points T2, T3, T4 in group D were lower than those in group P at the same time points, the levels of TNF-α at time points T1, T2, T3 in group D were lower than those in group P at the same time points, and the levels of SOD at T3, T4 in group D were lower than those in group P at the same time points, with statistical significance (all P ＜ 0.05). Conclusion The application of Dexmedetomidine in pediatric liver surgery can stabilize hemodynamics, improve local cerebral oxygen saturation, and reduce inflammatory response and oxidative stress response.

Key words： Children Liver surgery Dexmedetomidine Propofol Regional cerebral oxygen saturation

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	CHEN Zheng PENG Tuochao XIANG Zhen ZHANG Shuibing QU Shuangquan

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CHEN Zheng PENG Tuochao XIANG Zhen ZHANG Shuibing QU Shuangquan. Application effect of Dexmedetomidine in pediatric liver surgery[J]. 中国医药导报, 2021, 18(16): 99-103,108.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I16/99

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