阿托品预先用药对妇科手术中应用垂体后叶素致心率减慢的预防  

Application of Pretreatment with Atropine to Prevent Pituitrin Caused Bradycardia in Gynecologic Surgery

作　　者：刘慧芳[1] 韩志强[1] 于建设[1] 

机构地区：[1]内蒙古医科大学附属医院麻醉科,呼和浩特010050

出　　处：《医学综述》2015年第19期3603-3604,共2页Medical Recapitulate

基　　金：内蒙古卫生厅医疗卫生科研计划项目(2010031)

摘　　要：目的：观察阿托品预处理在子宫肌瘤剔除术中应用垂体后叶素致心率减慢的预防效果方法选择2012年11~12月内蒙古医科大学附属医院行子宫肌瘤剔除术手术的患者60例,美国麻醉医师协会Ⅰ~Ⅱ级,采用随机数字表法分为生理盐水组和阿托品组,各30例,均采用硬膜外麻醉,于注射垂体后叶素时阿托品组给予阿托品0．4 mg,生理盐水组给予等量生理盐水,分别观察注射前（ T0）、注射后2 min（ T1）、注射后5 min（ T2）、注射后15 min（ T3）、注射后25 min（ T4）患者心率、收缩压、舒张压的变化,记录高血压及心动过缓的发生率。结果与生理盐水组比较,阿托品组心动过缓的发生率明显降低（0比40．0%）（P〈0．01）。其中生理盐水组患者有12例发生心动过缓,阿托品组无一例出现；与T0比较,生理盐水组与阿托品组给予垂体后叶素后收缩压、舒张压均在T1-3时升高（P〈0．05）,生理盐水组HR在T1~3时明显降低（P〈0．05）；阿托品组心率在给垂体后叶素前后无明显变化（P〉0．05）。结论预先给予阿托品可有效预防在子宫肌瘤剔除术中应用垂体后叶素致心率减慢。Objective To observe the preventive effect of atropine pretreatment for pituitrin induced bradycardia in myomectomy. Methods A total of 60 patients who underwent routine myomectomy surgery in Affiliated Hospital of Inner Mongolia,ASA Ⅰ-Ⅱ,during November and December 2012 were divided into two groups by dynamic random grouping method：atropine group （ n=30 ） and saline group （ n =30 ） . The patients all received epidural anesthesia. In atropine group,atropine 0. 4mg was also injected when injecting pituitrin,while saline group was injected normal saline of the same amount. The heart rate（HR）,systolic blood pressure（ SBP） ,diastolic blood pressure（ DBP） before injection（ T0 ） ,2 min（ T1 ） ,5 min（ T2 ） ,15 min （ T3 ） and 25 min（ T4 ） after injection were recorded,and the incidence of hypertension and bradycardia was recorded as well. Results Compared with saline group,the incidence of bradycardia was decreased signifi-cantly in atropine group（0 vs 40. 0%）（P〈0. 01）. There were 12 patients of bradycardia in saline group, and no such case in atropine group. Compared with T0 ,the SBP,DBP of saline group and A at T1-3 were ele-vated（P〈0.05）,the HR of saline group at T1-3 were significantly decreased （P〈0.05）;HR of atropine group at T1-4 were not changed（P〉0. 05）. Conclusion Pretreatment with atropine can effectively prevent pituitrin caused bradycardia in gynecologic surgery.

关 键 词：子宫肌瘤 垂体后叶素 阿托品 麻醉 椎管内 

分 类 号：R452[医药卫生—治疗学]