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[胶原蛋白规范化治疗对结缔组织综合征患儿麻醉及术后并发症发生率和严重程度的影响]

[The effect of collagen-normalizing therapy on the incidence and severity of anesthetic and postoperative complications in children with connective tissue syndromes].

作者信息

Rudakov S S, Mikhel'son V A, Luk'ianov S V, Stepanenko S M, Prozorovskaia N N, Del'vig A A, Razuvaev M K

出版信息

Anesteziol Reanimatol. 1990 May-Jun(3):16-20.

PMID:2396760
Abstract

A new method of collagen-normalizing therapy has been worked out to prevent specific anesthesia-induced, operative and postoperative complications and to treat some symptoms in children with Ehlers-Danlos and Marfan's syndromes and with non-classified Marfan-like malformations. The technique involves a combined use of beta-adrenoblocker in the age-matched doses and vitamins C/0.03 g/(kg.day)/, B2/0.0004 g/(kg.day)/and B6/0.002 g/(kg.day)/ for 2.5 months before surgery and during the first 2 weeks of the postoperative period. The above therapy reduces the incidence of delayed recovery of the muscular tone and adequate respiration, spontaneous and recurrent pneumothorax, hemorrhagic and gastroenterologic complications, as well as the incidence and severity of intestinal paresis. The indexes of effective collagen-normalizing therapy are as follows: body weight increase, echocardiographic pattern of reduced diameter of the aorta and mitral valve prolapse, normalization of the urinary excretion of total and polypeptide-bound oxyproline. The efficacy of therapy depends on the baseline level of oxyproline excretion.

摘要

已研发出一种新的胶原正常化治疗方法,用于预防特定麻醉诱导的、手术中和术后的并发症,并治疗患有埃勒斯-当洛综合征、马凡综合征以及未分类马凡样畸形的儿童的一些症状。该技术包括在手术前2.5个月以及术后头两周,联合使用年龄匹配剂量的β-肾上腺素能阻滞剂以及维生素C/0.03 g/(kg·天)/、维生素B2/0.0004 g/(kg·天)/和维生素B6/0.002 g/(kg·天)/。上述治疗可降低肌肉张力延迟恢复和呼吸正常化、自发性和复发性气胸、出血性和胃肠并发症的发生率,以及肠道麻痹的发生率和严重程度。有效的胶原正常化治疗指标如下:体重增加、主动脉直径减小和二尖瓣脱垂的超声心动图表现、总羟脯氨酸和多肽结合羟脯氨酸尿排泄的正常化。治疗效果取决于羟脯氨酸排泄的基线水平。

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