甲氧明防治老年患者下肢骨科手术蛛网膜下腔阻滞后低血压的临床研究

发布时间：2018-01-16 03:32

本文关键词：甲氧明防治老年患者下肢骨科手术蛛网膜下腔阻滞后低血压的临床研究　出处：《重庆医学》2015年17期 　论文类型：期刊论文

【摘要】：目的观察肌肉注射甲氧明防治老年患者下肢骨科手术蛛网膜下腔阻滞后低血压的临床效果。方法择期行股骨颈骨折手术的老年患者60例,分为两组(n=30),肌肉注射甲氧明组(MX组):麻醉前10min给予甲氧明10mg臀深部肌肉注射;对照组即预扩容组(DR组):麻醉前20min静脉输注代斯500mL和乳酸钠林格液500mL。记录入室后60min内收缩压(SBP)、舒张压(DBP)和心率(HR)的变化。如出现低血压,予甲氧明1~2mg补救性注射。结果 DR组低血压发生率为77%,MX组为47%,组间比较差异有统计学意义(P0.05);应用甲氧明补救性注射在DR组为53%,MX组为27%,两组比较差异有统计学意义(P0.05);麻醉前DR组及MX组患者SBP均升高(与基础值比较),组间比较差异无统计学意义(P0.05);MX组HR下降且整个观察期均明显低于DR组。麻醉后两组SBP均明显下降(与基础值比较),但MX组收缩压始终高于DR组。结论对于血容量正常的老年患者,在蛛网膜下腔阻滞实施前10min给予甲氧明10mg肌肉注射,可提供更加稳定的血流动力学,同时,操作便利。
[Abstract]:Objective to observe the clinical effect of intramuscular injection of methoxifen on hypotension after subarachnoid block in lower extremity orthopaedic surgery in elderly patients. Two groups were divided into two groups: intramuscular injection of methoxifen 10 mg intramuscular injection of 10 mg deep gluteal injection before anesthesia; The control group (pre-dilatation group) received intravenous infusion of Deiss 500ml and sodium lactate Ringer's solution (500ml) 20 minutes before anesthesia. Systolic blood pressure (SBP) was recorded within 60 minutes after entering the room. The changes of DBP and HRR). If hypotension occurred, methoxifen 1mg was given to rescue injection. Results the incidence of hypotension in Dr group was 47%. The difference between the two groups was statistically significant (P 0.05). The number of patients treated with methoxifen for rescue injection in Dr group was 27 in 53x group, and the difference between the two groups was statistically significant (P 0.05). Before anesthesia, the SBP of Dr group and MX group were all increased (compared with the basic value, there was no significant difference between the two groups (P 0.05). The HR of MX group was decreased and the whole observation period was lower than that of Dr group. After anesthesia, the SBP of both groups decreased significantly (compared with the basic value). But systolic blood pressure in MX group was higher than that in Dr group. Conclusion for elderly patients with normal blood volume, 10 mg methoxifen was injected intramuscularly 10 min before subarachnoid block. Can provide more stable hemodynamics, at the same time, easy to operate.
【作者单位】：三峡大学仁和医院麻醉科;
【基金】：湖北省卫生厅资助项目(JX6C27)
【分类号】：R614
【正文快照】： 随着社会人口的老龄化,行下肢骨科手术老年患者呈上升趋势。腰硬联合麻醉因起效快,方便术后镇痛,是下肢手术常用的麻醉方法。低血压是最常见的蛛网膜下腔阻滞后并发症,据统计,老年患者蛛网膜下腔阻滞后低血压的发生率达25%~82%[1-2]。临床通常采用预扩容和使用血管活性药物预

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