不同剂量尼卡地平预防垂体后叶素诱发腹腔镜下子宫肌瘤切除术患者心血管不良反应的效果

发布时间：2018-06-11 13:48

本文选题：钙通道拮抗剂 + 垂体后叶素　；参考：《临床麻醉学杂志》2015年11期

【摘要】：目的研究不同剂量尼卡地平预防垂体后叶素诱发腹腔镜下子宫肌瘤切除术患者心血管不良反应的效果。方法选择拟在全麻下行腹腔镜子宫肌瘤切除术患者120例,采用随机数字表法,随机均分为四组:5、10、15μg/kg尼卡地平组(N1、N2、N3组)和对照组(C组)。所有患者均在子宫肌瘤切除前,经穿刺针于腹腔镜监视下刺入肌瘤瘤体周围肌层,回抽无血后注射垂体后叶素6U和生理盐水混合液10ml。于注射完毕后2min时,N1、N2、N3组分别注射尼卡地平5、10、15μg/kg,C组静脉注射生理盐水5ml。术中维持BIS值45~55。记录入室时(T0)、注射垂体后叶素即刻(T1)、注射后1min(T2)、2min(T3)、3min(T4)、5min(T5)、10min(T6)、20min(T7)、30min(T8)的MAP、HR;记录手术时间、子宫肌瘤瘤体数量及出血量。结果与T0时比较,T2时四组MAP明显降低、HR明显增快(P0.05),T5~T8时N3组MAP明显降低,C组MAP明显升高;T2~T6时N3组HR明显增快(P0.05)。与C组比较,T5~T8时N2、N3组MAP明显降低,T4~T7时N2、N3组HR明显增快(P0.05)。与N2组比较,T4~T7时N1组HR明显减慢,T4~T6时N3组HR明显增快(P0.05)。四组患者手术时间和出血量差异无统计学意义。结论尼卡地平可预防垂体后叶素(6U)诱发腹腔镜下子宫肌瘤切除术患者的心血管不良反应,其适宜剂量为10μg/kg。
[Abstract]:Objective to study the effects of different doses of nicardipine on cardiovascular adverse reactions in patients undergoing laparoscopic hysteromyomectomy. Methods one hundred and twenty patients undergoing laparoscopic hysteromyomectomy under general anesthesia were randomly divided into four groups (n = 10 10 渭 g/kg) and control group C (n = 10 10 渭 g/kg). Before hysterectomy, all the patients were punctured into the muscle layer around the tumor under the supervision of laparoscope by puncture needle, and then injected with 10 ml of pituitrin 6U and normal saline after blood withdrawal. At the end of 2min, normal saline was injected intravenously in group N _ (1) N _ (2) N _ (2) N _ (3) with nicardipine 1015 渭 g / kg ~ (-1) 路L ~ (-1). During operation, the BIS value was maintained at 45 to 55. The MAPHRs of T _ 0, T _ 1, T _ 1, T _ 2, T _ 3, T _ 4, T _ 5, T _ 6, T _ 7, T _ 7 and T _ 8 were recorded, and the number of uterine leiomyoma and the blood loss were recorded. Results compared with T0, map decreased significantly in T 2 group, HR increased significantly (P 0 05), map in N 3 group decreased significantly in T 5 T 8 group, map in C group increased significantly, HR in N 3 group increased significantly when T 2 + T 6 group and HR in N 3 group increased significantly (P 0 05) when T 2 and T 6 were higher than that at T 2 + T 2 + T 6 group (P < 0 05). Compared with group C, map in group N _ (2) N _ (3) decreased significantly at T _ (5) T _ (8) and HR of group N _ (2) N _ (3) increased significantly (P _ (0.05) at T _ (4) T _ (7). Compared with N _ 2 group, the HR of N1 group was significantly slower than that of N _ 2 group, and that of N _ 3 group was significantly increased at T _ 4 T _ 6 and N _ 3 group (P 0.05). There was no significant difference in operation time and bleeding volume among the four groups. Conclusion nicardipine can prevent adverse cardiovascular reactions in patients undergoing laparoscopic hysteromyomectomy with a suitable dose of 10 渭 g / kg.
【作者单位】：重庆市妇幼保健院(重庆市妇产科医院)手术麻醉科;
【基金】：重庆市卫生计生委医学科研面上项目(20142101)
【分类号】：R737.33

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