甲氧明对全身麻醉下择期进行非心脏手术患者全诱导期生命体征的影响

发布时间：2018-02-25 23:29

本文关键词： 甲氧明全身麻醉诱导期血流动力学　出处：《中国临床药理学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的观察甲氧明对全身麻醉下择期进行非心脏手术患者全诱导期生命体征的影响。方法将140例在全身麻醉下择期进行非心脏手术的老年患者,用随机数表法分为对照组和试验组,每组70例。对照组微量持续泵注0.9%Na Cl 4μg·kg~(-1)·min-1,试验组在麻醉诱导前微量持续泵注盐酸甲氧明4μg·kg~(-1)·min-1。比较2组患者麻醉诱导前5 min(T_0)、诱导后2 min(T_1)、插管即刻(T_2)、插管后1 min(T_3)、插管后5 min(T_4)、插管后10 min(T_5)的血压、心率、心肌酶水平和药物不良反应发生情况。结果试验组患者在T_1、T_2、T_3、T_4的收缩压(SBP)分别为(135.07±27.78),(131.34±33.28),(129.37±37.22),(132.47±32.21)mm Hg,对照组分别为(124.36±31.07),(103.61±31.49),(157.09±37.40),(124.00±27.13)mm Hg;试验组患者T_1、T_3、T_4的舒张压(DBP)分别为(65.44±8.34),(75.47±11.24),(78.59±12.57)mm Hg,对照组分别为(72.83±8.15),(91.25±8.38),(71.49±9.80)mm Hg。试验组患者T_1、T_3的心率分别为(66.03±9.75)、(70.71±10.16)次/分,对照组分别为(76.64±9.33),(80.43±8.32)次/分,差异有统计学意义(P0.05)。试验组和对照组患者T_6的肌酸激酶同工酶(CK-MB)水平分别为(0.84±0.23),(1.54±0.22)U·L~(-1),差异有统计学意义(P0.05)。对照组患者发生心动过缓2例(2.86%),恶心呕吐6例(8.57%),躁动4例(5.71%);试验组分别为2例(2.86%),5例(7.14%),3例(4.29%),差异无统计学意义(P0.05)。试验组患者心动过速和低血压的例数分别为2例(2.86%),3例(4.29%),麻黄碱用量为(3.25±2.07)mg,对照组心动过速和低血压的例数分别为10例(14.29%),16例(22.86%),麻黄碱用量为(6.21±1.68)mg,差异有统计学意义(P0.05)。结论甲氧明微量持续泵注给药在老年患者麻醉诱导中的应用可以维持血压和心率的稳定,降低药物不良反应发生率,降低对心肌的损伤。
[Abstract]:Objective to observe the effect of methoxifen on the total induced vital signs of patients undergoing elective non-cardiac surgery under general anesthesia. Methods 140 elderly patients undergoing elective non-cardiac surgery under general anesthesia were selected. The method of random number table was used to divide the two groups into two groups: control group and experimental group. There were 70 cases in each group. The control group was given 0.9 渭 g 路kg-1 NaCl 4 渭 g 路kg-1) 路min-1, and the experimental group was injected with methoxifen hydrochloride 4 渭 g 路kg-1 路min-1 before anesthesia induction. The comparison was made between the two groups of patients before anesthesia induction, 5 min after induction, 2 min after induction, 2 min after induction, 2 min after intubation, 1 min after intubation, 1 min after intubation, 5 min after intubation, 5 min after intubation. The blood pressure was 10 minutes after intubation. Heart rate, Results the systolic blood pressure (SBP) of the patients in the experimental group was 135.07 卤27.78T4 (129.37 卤37.222.47 卤32.21mm Hg.The control group was 124.36 卤31.077.73.61 卤31.497.157.09 卤37.124.00 卤27.134.00 卤27.13mm Hg, respectively) and the diastolic pressure of T3T4 was 65.44 卤8.34 卤7.34 卤12.57Hg / g, respectively, and that of the control group was 5.47 卤11.248.59 卤12.57Hg / g, respectively. The heart rate of T _ 1 and T _ 3 was 66.03 卤9.75 / min, 70.71 卤10.16 / min, respectively. In the control group, 80.43 卤8.32 times per minute, respectively. The levels of creatine kinase isozyme (CK-MBB) in the experimental group and the control group were 0.84 卤0.23 U 路L ~ (-1) and 1.54 卤0.22 U 路L ~ (-1), respectively. The difference was statistically significant (P = 0.05). There were 2 cases of bradycardia in the control group, 6 cases of nausea and vomiting, 8.57% of the patients with nausea and vomiting, 4 cases of restlessness and 5.71T. In the test group, there were 2 cases (2.86) and 5 cases (7.14) and 3 cases (4.29%) with no significant difference (P 0.05). The number of patients with tachycardia and hypotension in the test group was 2 cases (2.86%), 3 cases (4.29g), 3.25 卤2.07 mg / g of ephedrine, and 10 cases of tachycardia and hypotension in the control group, respectively. The dosage of ephedrine was 6.21 卤1.68 mg, and the difference was statistically significant (P 0.05). Conclusion the application of methoxifen in the induction of anesthesia in elderly patients can maintain the stability of blood pressure and heart rate. To reduce the incidence of adverse drug reactions and myocardial injury.
【作者单位】：内江市第一人民医院麻醉科;
【基金】：四川省卫生厅科研基金资助项目(120292)
【分类号】：R614.2

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