论文部分内容阅读
目的:研究酮咯酸氨丁三醇超前镇痛对儿童下腹腔镜手术应激反应及血浆血栓素A2(TXA2)和血小板颗粒膜蛋白(GMP140)水平的影响。方法:将60例2~12岁ASAⅠ~Ⅱ级择期行下腹手术的患儿以抽签法随机分为观察组和对照组各30例,观察组给予酮咯酸氨丁三醇进行超前镇痛,对照组不给予药物进行超前镇痛,比较两组患儿的应激反应、氧化损伤、血小板活化、不良反应情况。结果:(1)观察组术后30 min、6 h皮质激素、肾上腺素、去甲肾上腺素水平均低于对照组(P均<0.05),而术后12 h上述指标与对照组比较差异无统计学意义(P>0.05);(2)观察组术后30 min GMP140水平低于对照组(P<0.05);(3)观察组不良反应发生率6.67%(2/30),低于对照组的13.33%(4/30)。结论:对于儿童下腹腔镜手术,采用酮咯酸氨丁三醇超前镇痛能有效抑制应激反应和血小板激活,同时降低不良反应发生率。
Objective: To study the effect of ketorolac tromethamine on the stress response and the levels of TXA2 and GMP140 in children undergoing laparoscopic surgery. Methods: Sixty ASA Ⅰ ~ Ⅱ grade 2 ~ 12-year-old children undergoing elective abdominal operation were randomly divided into observation group and control group with 30 cases in each group. Patients in observation group were given ketorolac trometamol for preemptive analgesia, The control group was given no drugs for advanced analgesia. The stress response, oxidative damage, platelet activation and adverse reactions in both groups were compared. Results: (1) The levels of cortical hormone, epinephrine and norepinephrine in the observation group at 30 min after operation were significantly lower than those in the control group (all P <0.05), while those at 12 h after operation were not significantly different from those of the control group (2) The level of GMP140 in the observation group was lower than that in the control group at 30 min (P <0.05); (3) The incidence of adverse reactions in the observation group was 6.67% (2/30), lower than that in the control group Group 13.33% (4/30). Conclusion: For children under laparoscopic surgery, ketorolac tromethamine ahead of analgesia can effectively inhibit the stress response and platelet activation, while reducing the incidence of adverse reactions.