参附注射液用于老年患者经尿道前列腺电切术围手术期寒战反应的临床研究  

Clinical study of Shenfu injection on shivering response of elderly patients during perioperative period of transurethral resection of prostate

作　　者：柯纬祺[1] 王玉婷[1] 庄少惠[1] 纪璇[2] 郭绪铿[1] 刘德坤 杨晓寰[2] 程明华[1] KE Weiqi;WANG Yuting;ZHUANG Shaohui;JI Xuan;GUO Xukeng;LIU Dekun;YANG Xiaohuan;CHENG Minghua(Anesthesiology,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Traditional Chinese Medicine,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院麻醉科,广东汕头515041 [2]汕头大学医学院第一附属医院中医科,广东汕头515041

出　　处：《广东药科大学学报》2019年第6期834-837,共4页Journal of Guangdong Pharmaceutical University

基　　金：广东省中医药管理局资助项目(粤中医【2018】1号)

摘　　要：目的探讨参附注射液用于高龄患者腰硬联合麻醉下经尿道前列腺电切术防治寒战的疗效。方法将2018年1月-12月于我院在腰硬联合麻醉下行经尿道前列腺电切术患者80例,采用随机数字法分为对照组、参附组,每组各40例。参附组于麻醉前滴注参附注射液50 mL,对照组滴注0.9%NaCl注射液50 mL,记录患者入室基础体温及麻醉完成后、手术开始时、手术结束时的体温;患者寒战发生情况;两组患者血流动力学改变情况;记录恶心呕吐、头晕头痛等不良反应发生情况。结果与对照组比较,参附组患者3~4级寒战发生率显著下降(P<0.05);手术结束时,对照组患者体温明显低于参附组(P<0.05);随着麻醉手术开始,参附组患者心率呈下降趋势,心率较基础值及对照组明显下降(P<0.05);两组患者麻醉实施后血压均不同程度下降,但参附组患者血压更稳定(P<0.05)。两组患者不良反应发生率差异无统计意义(P>0.05)。结论腰硬联合麻醉下行经尿道前列腺电切术术前预注参附注射液,在增强心肌收缩力、改善心肌氧供、减少术中及术后寒战等方面有独特的作用,可以起到防治寒战及维持血流动力学平稳的疗效。Objective To investigate the effect of Shenfu injection on the prevention of shivering in the elderly patients undergoing the transurethral resection of prostate(TURP)under combined epidural and spinal anesthesia(CESA).Methods From January 2018 to December 2018,80 patients underwent TURP under CESA in our hospital.They were divided into the control group and reference group,40 cases in each group.Before anesthesia,50 mL of Shenfu injection was infused into Shenfu group,and 50 mL of 0.9%NaCl injection was infused into the control group.The basic body temperature of patients entering the room and the body temperature of patients after anesthesia,at the beginning of operation and at the end of operation were recorded.The occurrence of shivering,the hemodynamic change,and adverse reactions such as nausea,vomiting,dizziness and headache were recorded.Results Compared with the control group,the incidence of grade 3-4 shivering in the Shenfu group decreased significantly(P<0.05).At the end of the operation,the body temperature of the control group was significantly lower than that of the Shenfu group(P<0.05).With the beginning of the anesthesia operation,the heart rate of the Shenfu group showed a downward trend,and the heart rate was significantly lower than that of the control group(P<0.05).After the implementation of anesthesia,the blood pressure of the two groups decreased in varying degrees,but the blood pressure of the Shenfu group was more stable(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Shenfu injection before TURP under CESA has a unique role in enhancing myocardial contractility,improving myocardial oxygen supply,reducing intraoperative and postoperative shivering,which can prevent and treat shivering and maintain hemodynamic stability.

关 键 词：参附注射液 前列腺电切术 寒战 血流动力学 

分 类 号：R697[医药卫生—泌尿科学]