急性高容性血液稀释对美维松临床药效学的影响  

Effects of acute hypervolemic hemodilution on pharmacodynamics of mivacurium

作　　者：刘东水[1] 李胜德[2] 

机构地区：[1]青岛大学医学院,山东青岛266071 [2]泰山医学院附属泰山医院,山东泰安271000

出　　处：《泰山医学院学报》2015年第1期39-41,共3页Journal of Taishan Medical College

摘　　要：目的：观察择期手术前应用急性高容量血液稀释（ AHHD）对美维松药效学的影响。方法选择腹腔镜下全子宫切除手术60例，年龄35-60岁，ASA分级Ⅰ-Ⅱ级，随机分为两组：实验组（ AHHD 组即A组，n=30）和对照组（ C组，n=30），两组均在术前补充生理需要量，实验组用6%羟乙基淀粉溶液进行血液稀释。血液稀释后监测指标平稳10 min 静推美维松0.2 mg·kg^-1。对照组不采取任何措施，在麻醉诱导结束监测指标平稳后静推美维松0.2 mg·kg^-1。记录美维松起效时间（推药到T1=0时间）、作用时间（美维松注入后T1=0至T1恢复至对照25%的时间）、恢复指数：（T1恢复从25%的时间到T1恢复至75%的时间）。结果与C组相比，A组肌松起效时间明显延长（115 s vs 90 s P〈0.05）、作用时间分别是36 min、22 min（P〈0.05），恢复指数分别为11、8（P〈0.05）。结论 AHHD对美维松起效时间和作用时间均有延长。Obsjective：To evaluate the effects of acute hypervolemic hemodilution（ AHHD）on the pharmacodynamics of mivacurium. Methods：Thirty patients who received laparoscopy assisted radical hysterectomy of cervical cancer,and the estimated blood loss was more than 600 ml,aged 35y-60y in ASAⅠorⅡ were the experimental group：AHHD group （ group A,n=30）,and another thirty patients who received laparoscopy assisted selected resection of the corpus were cho-sen,and their estimated blood loss was less than 200 ml,aged 35y-60y in ASAⅠorⅡ,were the control group（group C, n=30 ）. Both groups were supplied with physiological requirement before the operation. In Group A 15 ml/kg 6%hydroxyethyl starch 130/0. 4 solution was infused via vein. 0. 2mg. kg^-1 of mivacurium was intravenously infused for Group A after AHHD stabilized for 10 minutes. As to the group C,mivacurium was intravenously infused after the trachea was intubated. The onset time（time from infused to T1 =0）,the clinical duration（T1 recovery of 25%）,and recovery in-dex（ T1 25% -75%）were recorded. Results：Compared to Group C,the onset time of Group A was obviously prolonged （115s vs 90s 〈0. 050）,the duration of the effects were 36min,and 22min respectively,and the recovery index were 11 and 8（ P 〉0. 05）respectively. Conclusion：The onset time and duration of mivacurium can be prolonged by AHHD.

关 键 词：急性高容量血液稀释 美维松 药效学 

分 类 号：R614[医药卫生—麻醉学]