摘要
目的研究表面麻醉下早产儿视网膜病变激光光凝术患儿的应激反应,为临床采取干预措施提供科学依据。方法抽取30例早产儿视网膜病变激光光凝术患儿在术前安静状态、手术结束时、术后1 h、术后24 h的静脉血,检测血中多巴胺、去甲肾上腺素、肾上腺素的浓度,以及记录这4个时间点的心率、血氧饱和度、呼吸、平均动脉压。结果多巴胺、去甲肾上腺素、肾上腺素的浓度组间比较差异有统计学意义(P<0.05);手术结束时上述3个指标,术后1 h患儿多巴胺、去甲肾上腺素的浓度高于术前安静状态的水平(P<0.05)。心率、血氧饱和度、呼吸、平均动脉压的数值组间比较差异有统计学意义(P<0.01)。术后24 h患儿心率、血氧饱和度、呼吸与术前安静状态的水平相比,差异有统计学意义(P<0.05)。结论表面麻醉下接受早产儿视网膜病变激光光凝术治疗的患儿在术中会产生应激反应,而且这种应激状态在术后24 h时仍然存在,提示自手术开始至术后24 h内应加强观察和护理。
Objective To investigate stress response of infants during the laser photocoagulation for retinopathy of prematurity （ROP） with topical anesthesia and provide scientific evidences for clinical interventions. Methods Venous blood of infants （n=30） who needed laser photocoagulation for ROP were sampled at four time points： preoperative quiet state, the end of operation, 1 hour and 24 hours after operation. The concentrations of dopamine, norepinephrine and epinephrine in plasma were measured and physiological parameters as heart rate （HR）, oxygen saturation of blood （SpO2）, respiratory rate （RR） and mean blood pressure （MBP） were recorded at the same time points. Results The comparison of concentrations of dopamine, norepinephrine and epinephrine had statistical significance among groups （P〈0.05）. At the end of operation, concentrations of dopamine, norepinephrine and epinephrine and those of dopamine, norepinephrine at 1 hour after operation were all higher than those in preoperative quiet state （P〈0.05）. The comparison of HR, SpO2, RR and MBP had statistical significance among groups （P〈0.01）. The HR, SpO2 and RR at 24 hours after operation had statistical significance when compared with those in preoperative quiet state （P〈0.05）. Conclusion Infants of ROP have stress response during laser photocoagulation with topical anesthesia and the reaction still exists 24 hours after operation. It suggests that sophisticated monitoring and care from the beginning of operation to 24 hour after operation are indispensible.
出处
《护理学报》
2013年第5期9-12,共4页
Journal of Nursing（China）
基金
广东省自然科学基金项目(S2011010004440)
关键词
早产儿视网膜病变
光凝术
应激反应
retinopathy of prematurity
laser photocoagulation
stress response
