摘要
目的探讨不同剂量羟考酮对体外循环(CPB)下心内直视手术患儿肺损伤的影响。方法选择择期CPB下行室间隔缺损修补术患儿60例,随机分为4组各15例,其中C组(对照组)术中给予等容量生理盐水;D1(低剂量羟考酮)组术中给予羟考酮0.08 mg/(kg·h);D2(中剂量羟考酮)组术中给予羟考酮0.12 mg/(kg·h);D3(高剂量羟考酮)组术中给予羟考酮0.15 mg/(kg·h);直至手术结束。对比四组患儿给药前(T1)、停CPB后2h(T2)、6h(T3)和12 h(T3)时,血浆中TNF-α、IL-6和IL-8的含量,患儿桡动脉血血气分析结果,并计算患儿呼吸指数(RI)、氧合指数(OI)与肺顺应性(C_L)。结果 D2、D3组与C组相比,T2、T3、T4时血浆中TNF-α和IL-8的含量明显降低,T3、T4时血浆中IL-6的含量明显降低(P<0.05);D2、D3组与D1组相比,T2、T3、T4时血浆中TNF-α和IL-8的含量及RI明显降低,而OI与C_L升高,D2组T3、T4时与D3组T2、T3、T4时血浆中IL-6的含量明显降低(P<0.05);D3组与D2组相比,T2、T3、T4时血浆中IL-8的含量及RI明显降低,T2、T3时TNF-α、IL-6明显降低,而OI与C_L升高(P<0.05)。结论羟考酮可以减轻CPB下心内直视手术患儿肺损伤程度,改善患儿肺功能,且在一定范围内与剂量呈正相关,这可能与其可以抑制CPB诱发的炎症反应相关。
Objective To investigate the effects of different doses of oxycodone on lung injury in children with open-heart surgery by cardiopulmonary bypass （CPB）. Methods A total of 60 patients with ventricular septal defect repair by CBP on selective time were selected and were divided into four groups according to a random number table, each group had 15 cases, among them, Group C （control group） was given equal volume of saline, D1 （low dose of oxycodone） group was given oxycodone 0.08 mg/（kg·h）; D2（medium dose of oxycodone） group was give oxycodone 0.12 mg/（kg·h）; D3 （high dose of oxycodone） group was given oxycodone 0.15 mg/（kg.h）; Until the end of the surgery. Before given drug（t1）, after CBP 2 h （t2）, 6 h （T3） and 12 h （T3）, the TNF-α, IL-6 and IL-8 in plasma of the four groups and the results of the analysis of the radial arterial blood gas in children were compared respectively; the respiratory index（RI）, oxygen index （OI） and lung compliance（CL） of the children were calculated and the changes were analyzed. Results Group D2 and D3 compared with group C, the serum TNF alpha and IL-8 levels were significantly lower at T2, T3, and T4, the serum content of IL-6 was significantly lower at T3 and T4 （P〈0.05）; Group D2 and D3 compared with D1, the serum TNF alpha, IL-8 and RI levels were significantly lower, but the OI and CL were higher, group D2 at T3, T4 while group D3 at T2, T3 and T4 the serum content of IL-6 was significantly lower（P〈0.05）; Group D3 compared with group D2, the levels of IL-8 and RI in plasma was significantly lower at T2, T3, T4, TNF alpha, IL-6 were significantly reduced at T2, T3, but OI and CL increased（P〈0.05）. Conclusion Oxycodone can relieve the hmg injury in children with open-heart surgery by extracorporeal circulation, and improve the lung function of children, and within a certain range,is positively correlated with its dose, which may be related to its ability of inhibiting inflammation induced by CPB.
出处
《中国现代医生》
2017年第35期9-11,15,共4页
China Modern Doctor
关键词
羟考酮
体外循环
室间隔修补术
肺损伤
Oxycodone
Extracorporeal circulation
Surgical repair of interventricular septum
Lung injury
作者简介
通讯作者
