盐酸戊乙奎醚复合多索茶碱对开胸术合并COPD患者的肺功能保护作用  

Effect of Penehyclidine Hydrochloride Combined with Doxofylline in Protecting the Pulmonary Function of the COPD Patients for Thoracotomy

作　　者：陈志远[1] 吴健华[1] 王玉珍[1] 李岩[1] 何荷蕃[1] 

机构地区：[1]福建医科大学附属第二医院麻醉科,泉州362000

出　　处：《福建医科大学学报》2011年第4期287-290,共4页Journal of Fujian Medical University

摘　　要：目的比较观察盐酸戊乙奎醚复合多索茶碱对开胸术合并慢性阻塞性肺疾病(COPD)患者的肺功能保护作用。方法 80例拟行开胸手术合并COPD的患者,术中给予单肺通气。随机分为对照组(A组)、盐酸戊乙奎醚组(B组)、多索茶碱组(C组)、盐酸戊乙奎醚复合多索茶碱组(D组),分别于侧卧双肺通气(TLV)10min时生理盐水40mL静脉注射、盐酸戊乙奎醚0.5mg肌肉注射、多索茶碱200mg/40mL静脉注射、盐酸戊乙奎醚0.5mg肌肉注射复合多索茶碱200mg/40mL静脉注射。观察4组T1、T2、T3、T4时间点的呼吸力学参数变化和血气分析参数变化及拔管时并发症。结果 B、C、D组较A组同时间点显著提高单、双肺通气时的胸肺顺应性(P<0.05),显著降低单、双肺通气时的气道峰压、气道平台压和气道阻力(P<0.05),D组较B、C组显著提高单、双肺通气时的胸肺顺应性,显著降低单、双肺通气时的气道压、气道平台压和气道阻力(P<0.05);B、C、D组较A组同时间点显著提高动脉血氧分压(PaO2)(P<0.05),D组较B、C组显著提高同时间点PaO2(P<0.05)。结论盐酸戊乙奎醚和多索茶碱均可以改善COPD患者开胸术术中肺功能,两种药物联合应用的作用更强。Objective To compare the effect of penehyclidine hydrochloride combined with doxofylline in protecting the pulmonary function of the COPD patients.Methods Eight COPD patients who were going to have thoracotomy.They were randomly divided into 4 groups： A（control group）,B（treated with penehyclidine hydrochloride）,C（treated with doxofylline）,D（treated with penehyclidine hydrochloride combined with doxofylline）.The subjects lay on one side and were respectively injected with normal saline 40 mL,iv,penehyclidine hydrochlordie 0.5mg,im,doxofylline 200 mg/40 mL,iv,penehyclidine hydrochlordie 0.5 mg iv plus doxofylline 200 mg/40 mL iv.They were observed on the parameter change of the respiratory mechanics and blood gases analysis in different time points,T1,T2,T3 and T4.Complication after removing the tubes were also observed.Results Compared with Group A,Group B,C and D had significant greater increase in pulmonary compliance when conducting one lung and both lungs ventilation（P0.05）,reducing obviously Ppeak,Pplat and airway resistance（P0.05）,which was detected at the same time as Group B;compared with Group B and C,Group D had significant greater increase in pulmonary compliance when conducting one lung and both lungs ventilation,reducing obviously Ppeak,Pplat and airway resistance.Group B,C and D had obvious greater increase of PaO2（P0.05） than that of Group A detected at the same time;compared with Group B and C,Group D had significant greater increase of PaO2 detected at the same time（P0.05）.Conclusion Both penehyclidine hydrochlordie and doxofylline can improve the pulmonary function of the COPD patients when conducting one-lung ventilation,and is therefore more suitable in protecting the pulmonary function of COPD patients when they were combined.

关 键 词：奎宁环类 胆碱能拮抗剂 茶碱 呼吸功能试验 肺疾病 慢性阻塞性 麻醉 全身 胸外科手术 

分 类 号：R614.2[医药卫生—麻醉学] R563.905[医药卫生—外科学]