甲氧明预处理对行冠脉旁路移植术患者全麻诱导期血流动力学的影响  

The hemodynamics effect of methoxamine pretreatment during induction of general anesthesia in patients with coronary artery bypass transplantation

作　　者：宋志冰[1] 周俊辉[1] 郝金国 郭迎春[1] 张立[1] SONG Zhibing ZHOU Junhui HAO Jinguo GUO Yingchun ZHANG Li(Chest Hospital of Henan Province, Zhengzhou 450008, Chin)

机构地区：[1]河南省胸科医院,河南郑州450008

出　　处：《临床医药实践》2017年第6期415-418,共4页Proceeding of Clinical Medicine

摘　　要：目的:观察甲氧明预处理对行冠脉旁路移植术患者全麻诱导期血流动力学的影响。方法:选取择期行冠脉旁路移植术患者64例,ASAⅡ~Ⅲ级,随机分为甲氧明组(M组)和对照组(C组),每组32例,注射麻醉诱导药后,M组采用甲氧明20μg/kg静脉注射,C组采用等量生理盐水注射。诱导期发生低血压时给予去甲肾上腺素静脉注射,发生严重心动过缓时给予山莨菪碱静脉注射。记录患者麻醉诱导前(T_0)、麻醉诱导后1 min(T_1)、气管插管后即刻(T_2)、气管插管后1 min(T3)、气管插管后3 min(T_4)、气管插管后6 min(T_5)、气管插管后10 min(T_6)的心率(HR)、收缩压(SBP)、舒张压(DBP)。记录患者低血压和严重心动过缓的发生率,以及去甲肾上腺素和山莨菪碱的总用量。结果:两组患者诱导后T_1~T_6时点的SBP、DBP与T_0时点比较都降低(P<0.05);M组的SBP和DBP在T_1~T_4时点高于C组(P<0.05);M组的HR在T_2时点低于C组(P<0.05)。C组低血压发生率和去甲肾上腺素总用量高于M组(P<0.05;两组心动过缓的发生率和山莨菪碱的总用量比较,差异无统计学意义(P>0.05)。结论:在冠脉旁路移植术患者,全麻诱导期采用甲氧明预处理,能够更好地保证血流动力学的平稳。Objective ：To observe the hemodynamics effect of methoxamine pretreatment during induction of general anes- thesia in patients with coronary artery bypass transplantation. Methods ： All 64 patients of elective coronary artery bypass trans- plantation, ASA 11 or 111 ,were randomly divided into two groups ： the methoxamine group （ group M ） and the control group （group C） ,32 cases in each group. Immediately after the injection of drug anesthesia induction,patients in group M received methoxamine 20 μg/kg intravenous injection,whereas in group C, patients received the same amount of saline intravenous in- jections. In the induction period, when the blood pressure of the patients were low,they would be injected norepinephrine, and when the patients oecured severe bradyeardia, they would be injected anisodamine. Record the heart rate （HR） , systolic blood pressure （SBP） and diastolic blood pressure （DBP） of the patients, before anesthesia induction （ To ）, 1 min after anesthesia induction （T1）, immediately after endotraeheal intubation （T2 ）, 1 min after endotracheal intubation （T3 ） ,3 min after tracheal intubation （T4 ） ,6 min after endotraeheal intubation （T5 ）, 10 rnin after endotracheal intubation （T6 ）. The incidence of hypo- tension and severe bradycardia were recorded, and the total dosage of norepinephrine and anisodamine were also recorded. Results： Comparison in the group, the SBP and DBP of the patients in the two groups after anesthesia at T1- T6 were decreased significantly when compared with that at TO （ P 〈 0.05 ）. Comparison between groups ： at T1- T4, the SBP and DBP in group M were higher than those of group C （ P 〈 0.05 ）, The HR in group M at Tz was lower than that of group C （ P 〈 0.05 ）, the inci- dence of hypotension and the total dosage of norepinephrine in group C were higher than those in group M （ P 〈 O. 05 ）, while the incidence of bradyeardia and the total dosage of anisodamine had no statistical differenc

关 键 词：甲氧明 全麻诱导期 冠脉旁路移植 

分 类 号：R614.2[医药卫生—麻醉学]