预注麻黄碱或甲氧明对骨科下肢手术松止血带患者循环系统的影响  

Influence of pre-injection of ephedrine or metoclopramide on circulatory system of patients with lower limb surgery loosening tourniquet in orthopedics department

作　　者：裴淼 王两忠[1] 杨帅[1] 何斌[1] 陈勇[1] PEI Miao;WANG Liang-zhong;YANG Shuai(Affiliated Hospital of Chengdu University,Chengdu 610000,China)

机构地区：[1]成都大学附属医院,四川省成都市610000

出　　处：《临床合理用药杂志》2018年第21期32-33,35,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨预注麻黄碱或甲氧明对下肢骨科手术松止血带患者循环系统的影响。方法选取2017年成都大学附属医院收治的行下肢手术且需使用止血带患者90例,随机分为A、B、C组,每组30例。A组放松止血带同时予以0.9%氯化钠溶液,B组在放松止血带的同时静脉注射麻黄碱,C组在放松止血带的同时静脉注射甲氧明。比较3组患者松止血带前(T0)、松止血带后即刻(T1)及其后1 min(T2)、3 min(T3)、5 min(T4)、10 min(T5)时心率(HR)与平均动脉压(MAP),并观察患者并发症发生情况。结果 T4、T5时,B组HR高于A组(P<0.05);T2、T3时,B、C组MAP高于A组(P<0.05);T4时,C组MAP高于A组(P<0.05)。A组T1、T2、T3、T4时HR高于T0,MAP低于T0(P<0.05);B组T2、T3、T4、T5时HR高于T0,T2时MAP低于T0(P<0.05);C组T2时HR高于T0,MAP低于T0(P<0.05)。3组并发症发生率比较,差异无统计学意义(P>0.05)。结论下肢骨科手术松止血带患者预注麻黄碱或甲氧明可有效预防血压降低,且甲氧明较麻黄碱更有利于保护心脏。Objective To investigate the influence of pre-injection of ephedrine or metoclopramide on circulatory system of patients with lower limb surgery loosening tourniquet in orthopedics department.Methods A total of 90 cases of patients with lower limb surgery with tourniquet were selected from 2017 in Affiliated Hospital of Chengdu University,which were randomly divided into A,B,C group,30 cases in each group.The A group was given 0.9% sodium chloride solution when loosening tourniquet,B group was given intravenous injection of ephedrine,C group was given intravenous injection of metoclopramide.The HR,MAP at the time of T0,T1,T2,T3,T4,T5 were compared between the two groups,and the incidence of complications were observed.Results At T4,T5,HR in B group was higher than A group（P〈0.05）;at T2,T3,B,C group of MAP were higher than A group（P〈0.05）;At T4,C group of MAP was higher than A group（P〈0.05）.A group of T1,T2,T3,T4 of HR were higher than T0,MAP were lower than T0（P〈0.05）;B group of T2,T3,T4,T5 of HR were higher than T0,T2 of MAP was lower than T0（P〈0.05）;C group of T2 of HR was higher than T0,MAP was lower than T0（P〈0.05）.No significant difference of the incidence rate of complications was found among three groups（P〈0.05）.Conclusion Ephedrine and methoxamine can both effectively prevent blood pressure lowering,but methoxamine appeare to be more beneficial for myocardial protection.

关 键 词：下肢手术 止血带 麻黄碱 甲氧明 

分 类 号：R614[医药卫生—麻醉学]