前列腺素E_1预防全麻气管内插管心血管副反应的观察  

Effects of prostaglandin E 1 on cardiovascular stress response to endotracheal intubation

作　　者：刘志双[1] 孟庆云[1] 柳顺锁[1] 魏淑明[1] 尹彦良 

机构地区：[1]河北医科大学第三医院麻醉科,石家庄050051

出　　处：《中华麻醉学杂志》1999年第5期279-282,共4页Chinese Journal of Anesthesiology

摘　　要：目的　为探讨前列腺素Ｅ１（ＰＧＥ１）预防全麻气管内插管所致心血管副反应的临床效果及作用机理。方法　６０ 例ＡＳＡⅠ～Ⅱ级择期手术患者随机分为三组，每组２０ 例，Ⅰ组（ＰＧＥ１ 组）：于气管内插管前１５～２０ 秒静脉注射前列腺素Ｅ１ ０．５μｇ／ｋｇ，Ⅱ组（表面麻醉组）：于气管内插管前１０ 分经环甲膜向气管内注射１％ 丁卡因２．５ｍ ｌ；Ⅲ组（对照组）。三组均以芬太尼、硫喷妥钠、琥珀胆碱静脉诱导后行气管内插管。于诱导前、窥喉插管即刻及插管后１．５、５ 分测定ＳＰ、ＤＰ、ＭＡＰ、ＨＲ、ＥＣＧ、ＳｐＯ２并计算ＲＰＰ。同期采取外周静脉血测定血浆ＮＥ、Ｅ、ＡＮＰ、ＥＴ、ＰＲＡ和ＡⅡ。结果　（１）血液动力学变化：Ⅰ组ＳＰ、ＤＰ、ＭＡＰ、ＨＲ、ＲＰＰ于插管前后无明显变化．Ⅱ组仅ＤＰ于插管后１．５分、ＲＰＰ于插管即刻及其后１．５ 分明显升高（Ｐ＜ ０．０５ 或０．０１）。Ⅲ组于插管即刻及其后１．５、５ 分ＳＰ、ＤＰ、ＭＡＰ、ＨＲ、ＲＰＰ均较诱导前明显升高（Ｐ＜ ０．０５ 或０．０１）；（２）内分泌变化：三组病人血浆ＮＥ、Ｅ于插管即刻及其后均较插管前基础值显著升高（Ｐ＜ ０．０５ 或０．０１），以Ⅰ组升高最甚。血浆ＡＮＰ在Ⅱ。Objective To investigate the ef ects and mechanism of prostaglandin E 1 on cardiovascular stress response to endotracheal intubation Method Sixty adult patients undergoing selective surgery(ASAⅠ～Ⅱ),were randomly divided into three groups (n=20 in each group) Group Ⅰ: intravenous infusion of prostaglandin E 1 0 5μg·kg -1 ,15～20 seconds before endotracheal intubation;group Ⅱ:intratracheal injection with 1% dicaine 2 5ml through interciconcentesis 10min before intubation;group Ⅲ: the control group Anesthesia was induced with fenanyl,thiopental and succinylcholine SP,DP,MAP,HR,ECG,SpO 2 and RPP were recorded before induction,during intubation and 1 5,5min after intubation respectively The peripheral venous blood samples were drawn at corresponding time to measure plasma concentration of noradrenaline (NE),adrenaline (E),artria natriuretic polypeptide (ANP),endotheline (ET),renin (PRA),angiotensin (AⅡ) by radioimmunoassay individually Result (1) Hemodynamic changes:No significant changes occurred in SP DP,MAP,HR,or RPP in group Ⅰ; In group Ⅱ, DP increased 1 5min after intubation and RPP increased makedly during and 1 5min after intubation;While during and 1 5,5min after intubation,SP,DP,MAP,HR and RPP in group Ⅲ increased significantly compared with basic level before induction (P<0 05 or 0 01) (2) Endocrine response:During and after intubation,NE and E level were increased significantly in three groups,especially in group Ⅰ (P<0 05 or 0 01);ANP increased in both group Ⅱ and Ⅲ (P<0 05 or 0 01),while kept stable in group Ⅰ;PRA and AⅡ were decrea

关 键 词：前列地尔 气管内插管法 心血管系统 麻醉 预防 

分 类 号：R614.2[医药卫生—麻醉学]