本文關(guān)鍵詞： 甲氧明 全身麻醉 誘導(dǎo)期 血流動(dòng)力學(xué)　出處：《中國臨床藥理學(xué)雜志》2017年13期 　論文類型：期刊論文

【摘要】：目的觀察甲氧明對全身麻醉下?lián)衿谶M(jìn)行非心臟手術(shù)患者全誘導(dǎo)期生命體征的影響。方法將140例在全身麻醉下?lián)衿谶M(jìn)行非心臟手術(shù)的老年患者,用隨機(jī)數(shù)表法分為對照組和試驗(yàn)組,每組70例。對照組微量持續(xù)泵注0.9%Na Cl 4μg·kg~(-1)·min-1,試驗(yàn)組在麻醉誘導(dǎo)前微量持續(xù)泵注鹽酸甲氧明4μg·kg~(-1)·min-1。比較2組患者麻醉誘導(dǎo)前5 min(T_0)、誘導(dǎo)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)的血壓、心率、心肌酶水平和藥物不良反應(yīng)發(fā)生情況。結(jié)果試驗(yàn)組患者在T_1、T_2、T_3、T_4的收縮壓(SBP)分別為(135.07±27.78),(131.34±33.28),(129.37±37.22),(132.47±32.21)mm Hg,對照組分別為(124.36±31.07),(103.61±31.49),(157.09±37.40),(124.00±27.13)mm Hg;試驗(yàn)組患者T_1、T_3、T_4的舒張壓(DBP)分別為(65.44±8.34),(75.47±11.24),(78.59±12.57)mm Hg,對照組分別為(72.83±8.15),(91.25±8.38),(71.49±9.80)mm Hg。試驗(yàn)組患者T_1、T_3的心率分別為(66.03±9.75)、(70.71±10.16)次/分,對照組分別為(76.64±9.33),(80.43±8.32)次/分,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組和對照組患者T_6的肌酸激酶同工酶(CK-MB)水平分別為(0.84±0.23),(1.54±0.22)U·L~(-1),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。對照組患者發(fā)生心動(dòng)過緩2例(2.86%),惡心嘔吐6例(8.57%),躁動(dòng)4例(5.71%);試驗(yàn)組分別為2例(2.86%),5例(7.14%),3例(4.29%),差異無統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組患者心動(dòng)過速和低血壓的例數(shù)分別為2例(2.86%),3例(4.29%),麻黃堿用量為(3.25±2.07)mg,對照組心動(dòng)過速和低血壓的例數(shù)分別為10例(14.29%),16例(22.86%),麻黃堿用量為(6.21±1.68)mg,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論甲氧明微量持續(xù)泵注給藥在老年患者麻醉誘導(dǎo)中的應(yīng)用可以維持血壓和心率的穩(wěn)定,降低藥物不良反應(yīng)發(fā)生率,降低對心肌的損傷。
[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 鹵27.78T4 (129.37 鹵37.222.47 鹵32.21mm Hg.The control group was 124.36 鹵31.077.73.61 鹵31.497.157.09 鹵37.124.00 鹵27.134.00 鹵27.13mm Hg, respectively) and the diastolic pressure of T3T4 was 65.44 鹵8.34 鹵7.34 鹵12.57Hg / g, respectively, and that of the control group was 5.47 鹵11.248.59 鹵12.57Hg / g, respectively. The heart rate of T _ 1 and T _ 3 was 66.03 鹵9.75 / min, 70.71 鹵10.16 / min, respectively. In the control group, 80.43 鹵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 鹵0.23 U 路L ~ (-1) and 1.54 鹵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 鹵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 鹵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.
【作者單位】： 內(nèi)江市第一人民醫(yī)院麻醉科;
【基金】：四川省衛(wèi)生廳科研基金資助項(xiàng)目(120292)
【分類號】：R614.2

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