血中,尿中カテコールアミン及び毛小皮形態を指標とした小児期手術侵襲の評価

概要

論文の詳細を見る
Plasma catecholamine levels were determined pre- and postoperatively in 70 children. Plasma epinephrine and norepinephrine levels were significantly elevated within 24 hrs postoperatively. Only plasma norepinephrine levels were correlated with surgical stress scores. Plasma epinephrine levels were higher in patients undergoing reoperation than those at the first operation. Plasma norepinephrine levels were reduced in patients receiving analgesics. The results were not associated with age. The duration of high catecholamine levels following operation was 3 to 4 days in children which was longer than that of adults. The changes of urinary catecholamine levels were similar to plasma catecholamine but did not correlate with surgical stress scores. Hair cuticles were located in parallel and there was a tendency of making mosaic formation after operation. Hair cuticle score was graded according to the postoperative changes of hair cuticle examined by scanning electron microscopy. Hair cuticle scores correlated with plasma norepinephrine and surgical stress scores. The examination of hair cuticle of rats in stress showed similar results. In conclusion, plasma catecholamine levels and hair cuticle scores can be an indicator of surgical stress in children.
日本小児外科学会の論文
1988-12-20