高珊珊

【摘要】 目的：研究術前不使用阿托品对腹腔镜疝气修补术患儿腺体分泌及血流动力学状态的影响。方法：选取2017年9月-2019年8月本院收治的行腹腔镜疝气修补术的50例患儿为研究对象。将其根据干预方式的不同分为对照组（术前皮下注射阿托品）25例和观察组（术前不使用阿托品）25例。比较两组的口干程度及血流动力学指标、喉痉挛发生情况。结果：观察组麻醉前30 min和对照组给药前的口干程度比较，差异无统计学意义（P>0.05）;麻醉后即刻和麻醉后30 min，观察组的口干程度均轻于对照组，差异均有统计学意义（P<0.05）。麻醉后即刻和麻醉后30 min，对照组的心率均明显高于观察组，差异均有统计学意义（P<0.05）。对照组的喉痉挛发生率为8.00%，与观察组的12.00%比较，差异无统计学意义（P>0.05）。结论：术前不肌注阿托品对腹腔镜疝气修补术患儿腺体分泌的影响明显，但未见喉痉挛发生率升高，且未对血流动力学状态的稳定造成显著不良影响，因此认为在本类手术患儿中术前可不应用阿托品。

【关键词】 术前 皮下注射 阿托品 腹腔镜疝气修补术 儿童 腺体分泌 血流动力学状态

[Abstract] Objective： To study the influence of Atropine without preoperative hypodermic injection for the gland secretion and hemodynamic state of children with laparoscopic repair of hernia. Method： A total of 50 children who underwent laparoscopic hernia repair in our hospital from September 2017 to August 2019 were selected as study subjects. According to the different intervention methods， they were divided into control group （subcutaneous injection of Atropine） with 25 cases and observation group （without Atropine） with 25 cases. The degree of xerostomia， hemodynamic indexes and laryngeal spasm were compared between the two groups. Result： There was no statistically significant difference in the degree of dry mouth between the observation group before anesthesia 30 min and control group before administration （P>0.05）; immediately after anesthesia and 30 min after anesthesia， the degree of dry mouth in the observation group was lighter than that in the control group， the differences were statistically significant （P<0.05）. Immediately after anesthesia and 30 min after anesthesia， the heart rate of the control group was significantly higher than those of the observation group， with statistically significant differences （P<0.05）. The incidence of laryngeal spasm in the control group was 8.00%， which was not statistically significant compared with 12.00% in the observation group （P>0.05）. Conclusion： Preoperative non-intramuscular injection of Atropine had a significant effect on the secretion of glands in children undergoing laparoscopic hernia repair， but there was no increase in the incidence of laryngeal spasm and no significant adverse effect on the stability of hemodynamic state. Therefore， Atropine should not be used preoperatively in children undergoing laparoscopic hernia repair.

[Key words] Preoperative Hypodermic injection Atropine Laparoscopic repair of hernia Children Gland secretion Hemodynamic state

First-authors address： Childrens Hospital Affiliated to Suzhou University， Suzhou 215000， China

doi：10.3969/j.issn.1674-4985.2020.23.031

疝气在儿童中并不少见，而对于采用手术治疗的患儿，微创手术应用率不断提升，故临床中关于腹腔镜疝气修补术的各方面研究是重点与热点[1-2]。术中安全作为本类手术患儿的重点研究方面，相关研究众多，其中阿托品等术前应用药物在腺体分泌抑制方面广受应用，但是也有研究认为，阿托品的应用可导致腺体分泌物黏稠，反而会影响到分泌物的排出，不良反应突出[3-5]。本研究就术前不肌注阿托品对腹腔镜疝气修补术患儿腺体分泌及血流动力学状态的影响进行研究与分析，现报道如下。