本文選題：髖關(guān)節(jié)置換術(shù) + 氫化潑尼松�。� 參考：《山東醫(yī)藥》2017年37期

【摘要】：目的探討預(yù)防性使用氫化潑尼松與甲氧明對(duì)老年患者髖關(guān)節(jié)置換術(shù)中血流動(dòng)力學(xué)的影響。方法選擇行髖關(guān)節(jié)置換術(shù)老年患者60例,采用隨機(jī)數(shù)字表法分為三組C組、MI組和MP組各20例。三組均給予全麻,于骨水泥灌注前均給予氫化潑尼松0.5 mg/kg靜滴。骨水泥灌注前1 min,C組、MI組分別給予生理鹽水1 m L、甲氧明1mg靜注;MP組給予甲氧明負(fù)荷劑量100μg經(jīng)微量泵靜脈輸注,之后以1~2μg/(kg·min)持續(xù)泵注10 min。記錄三組麻醉前5 min(T0)、骨水泥灌注前1 min(T_1)及骨水泥灌注后1 min(T_2)、3 min(T_3)、5 min(T_4)、10 min(T_5)、15 min(T_6)SBP、DBP、平均動(dòng)脈壓(MAP)、HR,并測(cè)定動(dòng)脈血乳酸(Lac)。記錄三組術(shù)中發(fā)生的低血壓、心動(dòng)過緩、心動(dòng)過速及術(shù)后惡心嘔吐、圍術(shù)期心血管事件。結(jié)果與T_1時(shí)比較,C組T_2、T_3、T_4時(shí)SBP、DBP、MAP降低,T_3、T_4、T_5時(shí)HR升高(P均0.05);MI組T_2時(shí)HR,T_4時(shí)SBP、DBP、MAP降低(P均0.05);MP組T_2、T_3、T_4、T_5、T_6時(shí)各時(shí)點(diǎn)SBP、DBP、MAP、HR比較,P均0.05。與T_1時(shí)比較,C組T_4、T_5時(shí)Lac水平升高(P均0.05);MI組T_5時(shí)Lac水平升高(P均0.05);MP組T_4、T_5、T_6各時(shí)點(diǎn)Lac水平比較,P均0.05。C組低血壓發(fā)生率高于MI組、MP組(P均0.05),MI組心動(dòng)過緩發(fā)生率高于MP組(P0.05),三組心動(dòng)過速、圍術(shù)期心血管事件發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論骨水泥灌注前預(yù)防性應(yīng)用氫化潑尼松與甲氧明可有效維持老年患者人工髖關(guān)節(jié)置換術(shù)中血流動(dòng)力學(xué)的穩(wěn)定;且甲氧明持續(xù)靜脈泵注變速給藥較單次靜脈注射給藥對(duì)HR的影響更小。
[Abstract]:Objective to investigate the effect of prophylactic use of prednisone and methoxifen on hemodynamics during hip arthroplasty in elderly patients. Methods Sixty elderly patients undergoing hip arthroplasty were randomly divided into three groups: group C (n = 20) and group MP (n = 20). All the three groups were given general anesthesia and hydroprednisone 0.5 mg/kg intravenous drip before bone cement perfusion. The MI group was given 1 mL normal saline one minute before the bone cement perfusion, and 100 渭 g methoxifen loading dose was injected intravenously through a micropump in the MP group with methoxifen 1mg, and then continued to be pumped for 10 minutes with 1 渭 min 2 渭 g/(kg min. Five minutes before anesthesia and one minute before bone cement perfusion were recorded in the three groups, and 1 minute after the infusion of bone cement, 1 minute after the infusion of bone cement, the two groups were recorded, and 1 min after the infusion of bone cement, 3 minutes after the infusion of bone cement, 3 mins, 5 mins, 15 mins, T6, SBP, DBP, HRs of arterial blood lactic acid, were measured. The incidence of hypotension, bradycardia, tachycardia, postoperative nausea and vomiting, perioperative cardiovascular events in the three groups were recorded. Results compared with T _ 1, SBPDBPU map decreased at T _ 2T _ 3 / T _ 4 in C group and increased at T _ (3) T _ (4) T _ (5) / T _ (5) T _ (5) T _ (all) T _ (2) T _ (map) in T _ (2) T _ (3) T _ (3) T _ (3) T _ (3) T _ (4) T _ 4 / T _ (5) T _ 6 in T _ 2T _ 3 / T _ 4 / T _ (5) in T _ 6 compared with 0.05 in T _ 2T _ (3) T _ (3) T _ (4) T _ 4 / T _ (5) / T _ (6). The level of Lac in group C was higher than that in group T _ 4 and T _ 5. The level of Lac in group T _ 5 was higher than that in group T _ 5. The Lac level in group T _ (4) and T _ (5) T _ (6) was higher than that in group (P = 0.05), and the incidence of bradycardia in group P was higher than that in group MP (P = 0.05), and the incidence of bradycardia in group C was higher than that in group MP (P < 0.05), and the incidence of bradycardia in group T _ (0.05) was higher than that in group M (P < 0.05). There was no significant difference in the incidence of cardiovascular events in perioperative period (P < 0.05). Conclusion the prophylactic application of prednisone and methoxifen before bone cement perfusion can effectively maintain the hemodynamic stability in the elderly patients undergoing hip replacement. The effect of continuous intravenous infusion of methoxifen on HR was less than that of single intravenous injection.
【作者單位】： 武漢大學(xué)中南醫(yī)院;十堰市太和醫(yī)院;
【分類號(hào)】：R687.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 徐健清;;甲氧明預(yù)防膝關(guān)節(jié)手術(shù)止血帶松氣后并發(fā)低血壓的效果[J];中國藥師;2012年09期

2 單立新;;肌肉注射甲氧明對(duì)下肢手術(shù)松止血帶后血流動(dòng)力學(xué)的影響[J];中國臨床藥理學(xué)與治療學(xué);2013年02期

3 任柏林;;靜脈預(yù)注小劑量甲氧明預(yù)防老年患者全身麻醉誘導(dǎo)期低血壓的療效觀察[J];中國醫(yī)藥導(dǎo)刊;2014年01期

4 司輝鋒;孟凡民;張加強(qiáng);李璐;;甲氧明對(duì)腹腔持續(xù)熱灌注老年患者血流動(dòng)力學(xué)的影響[J];中國老年學(xué)雜志;2014年09期

5 李璐;孫培春;孟凡民;張加強(qiáng);張輝;;甲氧明治療腰麻下剖宮產(chǎn)產(chǎn)婦術(shù)中低血壓的量-效關(guān)系[J];臨床麻醉學(xué)雜志;2014年05期

6 原保亭;;靜脈預(yù)注小劑量甲氧明預(yù)防老年患者全身麻醉誘導(dǎo)期低血壓的影響分析[J];醫(yī)學(xué)理論與實(shí)踐;2014年15期

7 周德祥;熊雙寶;熊雄;;甲氧明聯(lián)合阿托品預(yù)防老年患者全麻誘導(dǎo)期低血壓的臨床觀察[J];海南醫(yī)學(xué)院學(xué)報(bào);2012年09期

8 熊桂林;印武;魯竟;楊明鏡;王瑩;劉偉偉;黃啟文;;甲氧明和麻黃堿靜脈預(yù)注預(yù)防腰硬聯(lián)合麻醉下產(chǎn)婦低血壓作用分析[J];中華臨床醫(yī)師雜志(電子版);2011年04期

9 張麗;蔣奇明;;預(yù)注甲氧明和麻黃素對(duì)老年椎體成形術(shù)患者血流動(dòng)力學(xué)的影響比較[J];中國現(xiàn)代藥物應(yīng)用;2014年02期

10 羅剛健;池信錦;關(guān)健強(qiáng);黎尚榮;黑子清;陳秉學(xué);;預(yù)注甲氧明對(duì)剖宮產(chǎn)患者腰硬聯(lián)合麻醉術(shù)中低血壓的防治作用[J];廣東醫(yī)學(xué);2007年09期

相關(guān)會(huì)議論文 前1條

1 李均;;甲氧明在剖宮產(chǎn)患者腰硬聯(lián)合麻醉術(shù)中的應(yīng)用[A];2013年全國醫(yī)藥學(xué)術(shù)交流會(huì)暨臨床藥學(xué)與藥學(xué)服務(wù)研究進(jìn)展培訓(xùn)班論文集[C];2013年

相關(guān)碩士學(xué)位論文 前5條

1 王翔;不同劑量甲氧明與麻黃堿聯(lián)合預(yù)注對(duì)剖宮產(chǎn)母嬰的影響[D];山西醫(yī)科大學(xué);2015年

2 劉沖;預(yù)注不同劑量甲氧明在防治老年人股骨頭置換術(shù)中低血壓的臨床研究[D];長春中醫(yī)藥大學(xué);2015年

3 陳龍;持續(xù)輸注甲氧明對(duì)胸腔鏡手術(shù)麻醉期間低血壓的防治效果[D];吉林大學(xué);2016年

4 司輝鋒;預(yù)輸注甲氧明對(duì)腹腔持續(xù)熱灌注老年患者血流動(dòng)力學(xué)及血?dú)獾挠绊慬D];鄭州大學(xué);2014年

5 劉偉;Coload并用麻黃堿、甲氧明和體位干預(yù)對(duì)腰硬聯(lián)合麻醉下剖宮產(chǎn)母嬰的影響[D];山東大學(xué);2012年

，

本文編號(hào)：1853535