Osmolovskiĭ E O, Nikitinskaia L P
Urol Nefrol (Mosk). 1995 Mar-Apr(2):9-11.
Urological operations in children are made as a rule to correct congenital malformations. The prevention of operative injury to the child' body is secured only in conditions of adequate anesthesiological defense. This is possible only in availability of rapid information on cardiovascular, oxygen metabolic and hormonal statuses. Central hemodynamics, oxygen metabolism and hormonal findings have been summarized for 89 children. The above parameters were measured before and during plastic reconstruction of the upper urinary tract. Initially hyperkinetic hemodynamics because of inadequate premedication to control psychoemotional lability, changed for stable and hypokinetic circulation to the end of the operative intervention as a result of neuroleptanalgesia. Eukinetic trends were induced by balanced promedol analgesia throughout the operation. Concentrations of hydrocortisone, aldosterone and STH were on the increase, while T3 and T4 levels lowered. Hyperkinetic and eukinetic hemodynamics were observed postoperatively after neuroleptanalgesia and balanced promedol-including analgesia, respectively.
儿童泌尿外科手术通常是为了纠正先天性畸形。只有在充分的麻醉防护条件下,才能确保防止对儿童身体造成手术损伤。而这只有在能够快速获取心血管、氧代谢和激素状态信息的情况下才有可能实现。对89名儿童的中心血流动力学、氧代谢和激素指标进行了总结。上述参数在上尿路整形重建手术前和手术期间进行了测量。起初,由于术前用药不足无法控制精神情绪不稳定,导致血流动力学表现为高动力状态,而在手术干预结束时,由于神经安定镇痛,转变为稳定的低动力循环状态。在整个手术过程中,平衡丙帕他莫镇痛诱导了正常动力趋势。氢化可的松、醛固酮和生长激素的浓度升高,而T3和T4水平降低。神经安定镇痛和平衡丙帕他莫镇痛后,分别在术后观察到高动力和正常动力血流动力学状态。