参附注射液对止血带引起的下肢缺血-再灌注肺损伤的影响

发布时间：2018-05-16 17:50

本文选题：参附注射液 + 缺血-再灌注损伤　；参考：《临床麻醉学杂志》2017年07期

【摘要】：目的探讨参附注射液对止血带引起的下肢缺血-再灌注肺损伤的影响。方法选择行单侧下肢手术患者60例,男36例,女24例,ASAⅠ或Ⅱ级。将患者随机分为参附注射液组(SF组,n=32)和对照组(C组,n=28)。两组患者均采用腰-硬联合麻醉,给予0.75%布比卡因1.5ml,上电脑气压止血带(压力为300mm Hg)止血。SF组于上止血带致缺血前30min静脉泵入参附注射液1ml/kg(加入100ml生理盐水中),松止血带前5min再次泵入1ml/kg(加入50ml生理盐水中);C组在相同时点分别静脉注射等量复方乳酸钠。记录上止血带前(T_0)、松止血带后5min(T_1)、15min(T_2)、30min(T_3)的MAP和HR;采集静脉血测定血浆血栓素B2(TXB2)和丙二醛(MDA)浓度。结果与T_0时比较,T_1~T_3时两组MAP明显降低(P0.05);T_2、T_3时SF组MAP明显高于C组(P0.05)。两组患者HR组间组内差异均无统计学意义。T_2、T_3时SF组TXB2和MDA浓度明显低于C组(P0.05或P0.01)。结论参附注射液具有抗氧化作用,可减轻止血带所致的下肢缺血-再灌注肺损伤。
[Abstract]:Objective to investigate the effect of Shenfu injection on lower extremity ischemia reperfusion lung injury induced by tourniquet. Methods A total of 60 patients (36 males and 24 females) undergoing unilateral lower limb surgery were enrolled in this study. The patients were randomly divided into Shenfu injection group (SF group) and control group (C group). Both groups were treated with combined spinal-epidural anesthesia. 0.75% bupivacaine was given 1.5ml, and the computer pressure tourniquet (pressure was 300mm Hg) hemostatic. SF group was injected into Shenfu injection 1 ml / kg (added to 100ml normal saline, 5min was pumped into 1 ml kg / kg after adding 50ml before ischemia induced by upper tourniquet). Group C was given the same dose of compound sodium lactate at the same time point. The MAP and HRwere recorded in front of tourniquet and 5 mins after tourniquet. The concentrations of plasma thromboxane B _ 2 (TXB _ 2) and malondialdehyde (MDA) were measured in venous blood. Results the MAP of SF group was significantly higher than that of C group at T _ (1) and T _ (3) in comparison with that in T _ (+) _ (1) / T _ (3) group. The MAP of SF group was significantly higher than that of C group at T _ (2) / T _ (3). The concentration of TXB2 and MDA in SF group was significantly lower than that in group C (P0.05 or P0.01). Conclusion Shenfu injection has anti-oxidation effect and can alleviate lower limb ischemia-reperfusion lung injury induced by tourniquet.
【作者单位】：南京中医药大学第二附属医院麻醉科;
【基金】：南京市科技计划项目(201611004)
【分类号】：R614

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