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| 氧化亚氮对后路半椎体切除术患儿术后血细胞形态的影响 |
| Effect of nitrous oxide exposure on hematology in children and adolescents undergoing posterior hemivertebral resection |
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| DOI：10.12089/jca.2021.04.004 |
| 中文关键词: 氧化亚氮 半椎体切除术 血液学 围术期 儿童 |
| 英文关键词: Nitrous oxide Hemivertebra resection Hematology Perioperative period Child |
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| 中文摘要: |
目的 探讨术中氧化亚氮暴露对半椎体切除术患儿术后血细胞形态和数量的影响。
方法 回顾性分析2013年1月至2020年7月因先天性半椎体畸形接受后路半椎体切除术的患儿245例，男152例，女93例，年龄<18岁，根据术中是否使用氧化亚氮分为暴露组（n=143）和对照组（n=102）。比较术后发生贫血、大红细胞症、小红细胞症、红细胞大小不等症等血细胞形态学和白细胞减少、血小板减少等血液学改变情况。采用多重线性回归分析氧化亚氮吸入与平均红细胞体积的最大变化程度（dMCV）的相关性。
结果 暴露组与对照组均有较高的术后贫血发生率（55.9% vs 57.8%）。两组均未观察到大红细胞症。暴露组有7例（4.9%），对照组有3例（2.9%）红细胞大小不等症。暴露组和对照组各有50例（35.0%）和46例（45.1%）小红细胞症。暴露组和对照组各有2例（1.4%）和4例（3.9%）白细胞减少。对照组有3例发生血小板减少。两组血细胞异常发生率差异均无统计学意义。年龄与dMCV呈负相关。
结论 在接受后路半椎体切除术患儿中，使用氧化亚氮进行麻醉对围术期血液学指标无显著影响。 |
| 英文摘要: |
Objective To explore the effect of nitrous oxide exposure on blood cell morphology and number in children and adolescents undergoing posterior hemivertebral resection.
Methods A total of 245 children who received hemivertebral resection between January 2013 and July 2020, 152 males and 93 females, aged < 18 years, were screened in this retrospective analysis. The incidence of anemia, macrocytosis, microcytosis, anisocytosis, leukopenia and thrombocytopenia were recorded. Multiple linear regression was used to analyze the correlation between nitrous oxide exposure and peak changes of mean corpuscular volume (dMCV).
Results A total of 245 children were included: 102 received air + oxygen during anesthesia maintenance (control group) and 143 received nitrous oxide + oxygen (exposure group). There was a high incidence of anemia in both groups. Fifty-nine (57.8%) children in the control group and 80 (55.9%) children in the exposure group had postoperative anemia. No macrocytosis was observed, while there were respectively 3 (2.9%) and 7 (4.9%) children with anisocytosis in the control group and the exposure group. Forty-six children (45.1%) were with microcytosis in the control group and 50 children (35.0%) in the expesure group. There were 4 (3.9%) and 2 (1.4%) children with leukopenia in the control group and the exposure group. And only 3 children in the control group developed thrombocytopenia. Age was negatively correlated with dMCV.
Conclusion Nitrous oxide anesthesia is probably not associated with perioperative hematology changes in children under 18 years old undergoing hemivertebral resection. |
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