《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (06): 469-470.

• 临床研究 • 上一篇    下一篇

脑瘫患儿诱导气管插管过程中自主神经功能的变化

纪宏   

  1. 广东省江南医院麻醉科 广东广州市 510300
  • 收稿日期:2004-10-26 出版日期:2005-06-25 发布日期:2005-06-25

Changes of the autonomic nervous system during induction and intubation of children with cerebral palsy

JI Hong   

  1. The Department of Anesthesiology, The Jiangnan Hospital, Guangzhou 510300, Guangdong, China
  • Received:2004-10-26 Published:2005-06-25 Online:2005-06-25

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摘要： 目的探讨脑瘫患儿腹部手术全麻诱导气管插管过程中自主神经系统功能的变化。方法应用心率变异性(HRV)分析法分析30例择期脑瘫患儿腹部手术(A组)和30非脑瘫患儿腹部手术(B组)麻醉前、麻醉诱导后、气管插管后的心率变异性。结果麻醉诱导后A组的低频(LF)、高频(HF)、LF/HF、总张力(TP)降低,B组的LF、LF/HF及TP亦降低,但HF末见明显改变;气管插管后两组的HRV值均升高;麻醉诱导后及气管插管后A组的HF和TP低于B组(P<0.05～0.01),而LF与B组间无显著性差异。结论麻醉诱导气管插管过程中脑瘫患儿神经活性及总自主神经张力低于非脑瘫患儿,脑瘫患儿迷走神经对心脏窦房结的调控作用受损。

关键词: 脑性瘫痪, 全身麻醉, 自主神经系统, 心率变异性

Abstract: ObjectiveTo investigate the changes of the autonomic nervous system during induction and intubation of children with cerebral palsy.MethodsThirty children with cerebral palsy (group A) and thirty children without cerebral palsy disease (group B) scheduled for abdominal operation were selected. Heart rate variability (HRV) was assessed before operation, after anesthesia induction and after trachea intubation using heart rate power spectrum analysis (HRPSA).ResultsAfter anesthesia induction, low frequency (LF), high frequency (HF), LF/HF and total pull (TP) decreased significantly in group A, and LF, LF/HF and TP decreased significantly in group B. After trachea intubation, LF, HF, LF/HF and TP increased significantly in both groups. During induction and intubation, HF and TP in group A was lower than that in group B significantly (P<0.05～0.01), but LF did not changed markedly in both groups.ConclusionParasympathetic nervous activity and the total power of autonomic nervous system are decreased significantly during induction and intubation in children with cerebral palsy compared with those without cerebral palsy, indicating that the effect of parasympathetic nervous activity is impaired.

Key words: cerebral palsy, general anesthesia, autonomic nervous system, heart rate variability