殷卓 于生喜 刘明

【摘要】 目的：探究與观察阿芬太尼联合七氟烷对扁桃体摘除术患儿血流动力学、凝血及疼痛介质表达的影响。方法：选取2019年1月-2020年3月本院80例扁桃体摘除术患儿，按照随机数字表法将其分为对照组和观察组，每组40例。对照组采用丙泊酚联合阿芬太尼麻醉，观察组采用阿芬太尼联合七氟烷麻醉。比较两组血流动力学指标（HR、MAP）、凝血指标（APTT、TT、PT）及疼痛介质（血清PGE2、SP、5-HT）。结果：麻醉前，两组HR、MAP、APTT、TT、PT比较，差异均无统计学意义（P>0.05）;麻醉后5 min及拔管后5 min，观察组HR、MAP、APTT、TT、PT均低于对照组，差异均有统计学意义（P<0.05）。麻醉前，两组PGE2、SP、5-HT比较，差异均无统计学意义（P>0.05）;术后2、4、6 h，观察组PGE2、SP、5-HT均低于对照组，差异均有统计学意义（P<0.05）。结论：阿芬太尼联合七氟烷对扁桃体摘除术患儿血流动力学、凝血及疼痛介质表达的影响相对更为积极，应用价值相对更高。

【关键词】 阿芬太尼 七氟烷 扁桃体摘除术 血流动力学 凝血 疼痛介质

Study on the Influence of Alfentanil Combined with Sevoflurane for Hemodynamics， Coagulation and Pain Mediators of Children with Tonsillectomy/YIN Zhuo， YU Shengxi， LIU Ming. //Medical Innovation of China， 2021， 18（29）： -173

[Abstract] Objective： To investigate and observe the influence of Alfentanil combined with Sevoflurane for hemodynamics， coagulation and pain mediators of children with tonsillectomy. Method： A total of 80 children with tonsillectomy in our hospital from January 2019 to March 2020 were selected， and they were divided into control group and observation group according to random number table method， 40 cases in each group. The control group was treated with Propofol combined with Alfentanil， and the observation group was treated with Alfentanil combined with Sevoflurane. Hemodynamic indexes （HR， MAP）， coagulation indexes （APTT， TT， PT） and pain mediators （serum PGE2， SP and 5-HT） were compared between two groups. Result： Before anesthesia， there were no significant differences in HR， MAP， APTT， TT and PT between two groups （P>0.05）; 5 min after anesthesia and 5 min after extubation， HR， MAP， APTT， TT and PT in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. Before anesthesia， there were no significant differences in PGE2， SP and 5-HT between two groups （P>0.05）; 2， 4 and 6 h after surgery， PGE2， SP and 5-HT in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The effects of Alfentanil combined with Sevoflurane on hemodynamics， coagulation and expression of pain mediators in children with tonsillectomy are relatively more positive， and the application value is relatively higher.

[Key words] Alfentanil Sevoflurane Tonsillectomy Hemodynamics Coagulation Pain mediators

First-authors address： Dalian Women and Childrens Medical Group， Dalian 116000， China

doi：10.3969/j.issn.1674-4985.2021.29.042

扁桃体摘除术在儿童中并不少见，而手术相关的麻醉等方面的研究是临床重点。对于本类患儿进行麻醉方式的选择过程中，安全性要求相对更高，麻醉对于机体多方面的影响也是评估的重点。血流动力学、凝血及疼痛介质等受麻醉影响较大，且是与手术效果及术后康复等密切相关的方面，其在扁桃体摘除术患儿中的监测价值较高，同时也是评估麻醉方式及用药的重要参考条件[1-2]。临床中将七氟烷用于小儿麻醉的研究并不少见，而与阿芬太尼联合用药，对于扁桃体摘除术患者的针对性应用研究乏见[3-5]。因此，本研究就阿芬太尼联合七氟烷对扁桃体摘除术患儿血流动力学、凝血及疼痛介质表达的影响进行探究，现报道如下。

1 资料与方法

1.1 一般资料 选取2019年1月-2020年3月本院80例行扁桃体摘除术患儿。纳入……