盐酸戊乙奎醚对急性失血性休克患者围术期血乳酸盐水平及氧代谢的影响  

Effect of penehyclidine on perioperative blood lactate levels and oxygen metabolismin in acute hemorrhagic shock patients

作　　者：李文媚[1] 张曙[1] 石海燕[1] 

机构地区：[1]广东省东莞市人民医院麻醉科,523018

出　　处：《中国医药》2009年第6期457-459,共3页China Medicine

摘　　要：目的观察盐酸戊乙奎醚对急性失血性休克患者围术期血乳酸盐水平和氧代谢的影响，探讨其对失血性休克患者的治疗作用。方法将96例急性失血性休克行剖腹探查术患者采用McLeod改良的Wichmann-Hill伪随机数发生器生成的随机序列分成2组，各48例。治疗组在手术开始时静脉注射盐酸戊乙奎醚0．05mg／kg，对照组静脉注射等量容积的0．9％NaCl溶液。分别记录输注前、注药后30、60、120min4个时点的动脉血乳酸盐浓度（BL）及氧代谢指标。同时监测平均动脉压、中心静脉压、心输出量、心率及排尿量的变化。结果2组患者注药后30、60min的中心静脉压、平均动脉压与输注前比较有所回升，且治疗组较对照组回升明显，差异有统计学意义（均P〈0．05）；心率在注药后30、60min与输注前比较下降，且治疗组较对照组下降明显，差异有统计学意义（均P〈0．05）；尿量在注药后60、120min与输注前比较增多（P〈0．05），且治疗组较对照组增多更明显（P〈0．05）。2组患者在注药后氧输送量、氧耗量与输注前比较均上升，且治疗组高于对照组（P〈0．05）；治疗组心输出量在注药后60、120min时点上升（P〈0．05），对照组注药后120min时点上升；BL浓度进行性下降（P〈0．05）；治疗组氧摄取率在注药后30、60min时点下降（P〈0．05），对照组氧摄取率各时点与输注前比较无明显变化。结论围术期盐酸戊乙奎醚用于抢救急性失血性休克患者可有效地改善氧供及氧利用率，减轻乳酸酸中毒，恢复正常的组织代谢。Objective To evaluate the effect of penehyclidine on perioperative blood lactate levels and oxygen metabolismin in acute hemorrhagic shock patients. Methods Ninety-six patients with acute hemorrhagic shock was given laparotomy. Treatment group （ n = 48 ） and control group （ n = 48 ） were divided based on MeLeod improved Wichmann-Hill pseudo-random number-generated hair-random sequence. Both groups underwent intubation general anesthesia. In treatment group patients were given penehyclidine 0.05 mg/kg. Respectively records were collected before infusion, 30 min, 60 min, 120min after injection simultaneous blood lactate concentration （BL）,and oxygen metabolism simultaneous monitoring MAP, CVP, heart output （CO）, urine output and heart rate changes. Results MAP, CVP in both groups increased 30 min, 60 min, 120min after injection. Furthermore the treatment group increased than significantly higher the control group （ P 〈 0.05 ）. Heart rate in both groups decreased 30 min and 60 min after injection. CO in the treatment group was higher 60min, 120 min after injection than that in the control group （P 〈0.05）. DO2, VO2 in the treatment group was higher 30 min,60 min after injection than that in the control group （ P 〈 0. 05）. Conclusion Pefioperative penehyclidine in the treatment of acute hemorrhagic shock patients is effective for oxygen and oxygen utilization and reduces lactic acidosis and restore normal metabolism.

关 键 词：失血性休克 围术期 盐酸戊乙奎醚 血乳酸盐 氧代谢 

分 类 号：R605.971[医药卫生—急诊医学]