盐酸戊乙奎醚对非停跳冠状动脉搭桥术后患者肺部并发症发生的预防效果  

Efficacy of penehyelidine hydrochloride for prevention of postoperative pulmonary complications in patients undergoing off-pump coronary artery bypass grafting

作　　者：林多茂[1] 卢家凯[1] 闫旭明[1] 兰琼[1] 李泽[1] 王慧敏[1] 赵丽云[1] 王义军[1] 卿恩明[1] 

机构地区：[1]首都医科大学附属北京安贞医院麻醉科,100029

出　　处：《中华麻醉学杂志》2013年第3期293-295,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价术前静脉注射盐酸戊乙奎醚对非停跳冠状动脉搭桥术后患者肺部并发症（PPc）发生的预防效果。方法非停跳冠状动脉搭桥术患者140例，性别不限，年龄35～80岁，体重55～80kg，ASA分级Ⅱ或Ⅲ级。采用随机数字表法，将其分为2组（n=70）：对照组（C组）和盐酸戊乙奎醚组（P组）。于气管插管后即刻P组缓慢静脉注射盐酸戊乙奎醚20μg／kg（5m1），C组以等容量生理盐水替代。记录术后72h内患者PPC的发生情况。结果C组和P组PPC发生率分别为33％和16％。与C组比较，P组PPC发生率降低（P〈0．05）。结论术前静脉注射盐酸戊乙奎醚20μg／kg可预防非停跳冠状动脉搭桥术患者PPC的发生。Objective To evaluate the efficacy of penehyelidine hydrochloride for prevention of postopera- tive pulmonary complications （PPCs） in patients undergoing off-pump coronary artery bypass grafting （OPCABG）. Methods One hundred and forty ASAⅡ or Ⅲpatients of both sexes, aged 35-80 yr, weighing 55-80 kg, under- going OPCABG, were randomly divided into 2 groups （ n = 70 each） ： control group （group C） and penehyelidine hydrochloride group （ group P）. Anesthesia was induced with iv injection of midazolam, etomidate, sufentanil and rocuronium. The patients were mechanically ventilated after tracheal intubation. PET CO2 was maintained at 35- 40 mm Hg. Penehyelidine hydrochloride 20μg/kg （5 ml） was injected intravenously and slowly immediately after tracheal intubation in group P. While the equal volume of normal saline was administered instead in group C. An- esthesia was maintained with iv infusion of propofol, intermittent iv boluses of sufentanil and pipecuronium, and in- halation of sevoflurane. BIS value was maintained at 40-50. The occurrence of PPCs was recorded within 72 h after operation. Results The incidences of PPCs were 33 % and 16 % in groups P and C, respectively. The incidence of PPCs was significantly lower in group P than in group C （ P 〈 0.05 ）. Conclusion Intravenous injection of penehyclidine hydrochloride 20μg/kg before operation can prevent the occurrence of PPCs in patients undergoing OPCABG.

关 键 词：胆碱能拮抗剂 冠状动脉旁路移植术 非体外循环 手术后并发症 

分 类 号：R473.6[医药卫生—护理学]