心宝丸预防颈动脉支架植入术围手术期低血流动力学的临床研究  

Clinical study of the efficacy of Xinbao pills in the prevention of hemodynamic depression in the perioperative period of carotid artery stenting

作　　者：叶远鹏 赵超[1] 梁亚龙 董健[1] 王吉昌[1] 黄勋 冯骏[1] Ye Yuanpeng;Zhao Chao;Liang Yalong;Dong Jian;Wang Jichang;Huang Xun;Feng Jun(Department of Vascular Surgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院血管外科,陕西西安710061

出　　处：《中国血管外科杂志（电子版）》2023年第4期342-345,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨心宝丸使用对颈动脉支架植入术围手术期低血流动力学的影响。方法回顾性分析2015年7月至2021年12月西安交通大学第一附属医院收治的248例入院心率<70次/min的颈动脉狭窄患者临床资料,并按照术前是否使用心宝丸分为心宝丸组(90例)和对照组(158例)。比较两组患者术中最低血压、心率、阿托品和去甲肾上腺素使用情况、术后血流动力学状态和并发症情况。结果心宝丸组患者术中最低收缩压[(106.24±9.98)mmHg vs(95.43±10.26)mmHg,P<0.001]、最低心率[(53.21±6.13)次/min vs(44.61±4.76)次/min,P<0.001]均显著高于对照组,且术中使用阿托品的例数(31.11%vs 46.83%,P=0.016)及剂量[(0.85±0.29)mg vs(1.38±0.41)mg,P=0.001]均明显低于对照组,差异有统计学意义;心宝丸组术后低血流动力学发生率(低心率:16.67%vs 29.11%,P=0.029;低血压:23.33%vs 35.44%,P=0.047)、使用升压药物时间量[(12.42±2.48)h vs(23.45±3.62)h,P=0.011]及术后并发症发生率(3.33%vs 11.39%,P=0.028)明显低于对照组,差异有统计学意义。结论心宝丸能明显改善颈动脉支架植入术后患者低血流动力学情况,缩短升压药物使用时间并减少并发症的发生。Objective To investigate the effect of Xinbao pills on hemodynamic depression in the perioperative period of carotid artery stenting.Methods The clinical data of 248 carotid artery stenosis patients with heart rate<70 beats/min admitted to the First Affiliated Hospital of Xi'an Jiaotong University from July 2015 to December 2021 were analyzed retrospectively.They were divided into Xinbao pill group(90 cases)and control group(158 cases).The intraoperative minimum blood pressure,heart rate,atropine and norepinephrine usage,postoperative hemodynamic status and complications were compared between the two groups.Results The lowest systolic blood pressure(106.24±9.98 mmHg vs 95.43±10.26 mmHg,P<0.001),the lowest heart rate(53.21±6.13 beats/min vs 44.61±4.76 beats/min,P<0.001)of Xinbao pill group were significantly higher than those in the control group,and the number of cases(31.11%vs 46.83%,P=0.016)and dose(0.85±0.29 mg vs 1.38±0.41 mg,P=0.001)of atropine in the Xinbao pill group were significantly lower than those in the control group,and the difference was statistically significant.The incidence of postoperative hemodynamic depression in the Xinbao pill group(low heart rate:16.67%vs 29.11%,P=0.029;hypotension:23.33%vs 35.44%,P=0.047),the duration of using vasopressor drugs(12.42±2.48h vs 23.45±3.62h,P=0.011)and the incidence of postoperative complications(3.33%vs 11.39%,P=0.028)were significantly lower than that of the control group,and the difference was statistically significant.Conclusion Xinbao pills can significantly improve the hemodynamic depression,shorten the duration of using vasopressor drugs and reduce the occurrence of complications for patients after carotid artery stenting.

关 键 词：颈动脉 动脉狭窄 颈动脉支架成形术 中药 血流动力学 

分 类 号：R651.12[医药卫生—外科学]