甲氧明与去氧肾上腺素在颈动脉内膜剥脱术中的临床疗效  

Clinical efficacy of methoxyamine and deoxyadrenaline in carotid endarterectomy

作　　者：艾克拜尔•努尔买买提 李珊珊 何金盼 苏日青[2] 古兰旦木•艾合麦提 叶建荣[1] Aikebaier•Nuermaimaiti;Li Shanshan;He Jinpan;Su Riqing;Gulandamu•Aihemati;Ye Jianrong(DepartmentⅡof Anesthesiology,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Key Laboratory of Perioperative Organ Protection,Urumqi 830054,Xinjiang,China;DepartmentⅠof Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China;Department of Coronary Heart Disease,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院麻醉科,新疆围术期器官保护重点实验室,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院神经外二科,新疆乌鲁木齐830054 [3]新疆医科大学第一附属医院冠心病一科,新疆乌鲁木齐830054

出　　处：《血管与腔内血管外科杂志》2024年第10期1211-1215,共5页Journal of Vascular and Endovascular Surgery

基　　金：2024年度省部共建中亚高发病成因与防治国家重点实验室-高原病专项项目(SKL-HIDCA-2024-GY6)。

摘　　要：目的探讨甲氧明与去氧肾上腺素在颈动脉内膜剥脱术中的临床疗效。方法收集2022年6月至2023年6月于新疆医科大学第一附属医院实施颈动脉内膜剥脱术治疗的126例患者的临床资料,按照治疗方法的不同将其分为对照组(n=61,静脉泵注去氧肾上腺素)和研究组(n=65,静脉泵注甲氧明)。比较两组患者血流动力学指标、冠状动脉血流情况、心脏功能指标以及围术期不良反应发生情况。结果起始泵药后10 min、30 min时,两组患者平均动脉压(MAP)水平均高于本组泵药前、起始泵药后1 min,差异均有统计学意义(P﹤0.05)。起始泵药后30 min,两组患者冠状动脉窦收缩期血流速度时间积分(SVTI)、舒张期血流速度时间积分(DVTI)、冠状动脉窦血流量(CSBF)水平均高于本组泵药前,研究组患者DVTI、CSBF水平高于对照组患者,差异均有统计意义(P﹤0.05)。起始泵药后30 min,两组患者每搏输出量(SV)、每搏左心室做功(LVSW)水平均高于本组泵药前,且研究组患者SV、LVSW水平均高于对照组患者,差异均有统计学意义(P﹤0.05)。围手术期研究组患者不良反应总发生率为3.08%(2/65),与对照组患者的6.56%(4/61)比较,差异无统计学意义(P﹥0.05)。结论与去氧肾上腺素比较,甲氧明用于颈动脉内膜剥脱术中可更好维持其血压平稳,可增加冠状动脉血流,保护心脏功能。Objective To investigate the clinical efficacy of methoxyamine and deoxyadrenaline in carotid endarterectomy.Method Clinical data of 126 patients who underwent carotid endarterectomy in the First Affiliated Hospital of Xinjiang Medical University from June 2022 to June 2023 were collected.According to different treatment methods,they were divided into control group(n=61,intravenous pump injected with norepinephine)and study group(n=65,intravenous pump injected with methoxamine).Hemodynamic indexes,coronary artery flow,cardiac function indexes and perioperative adverse reactions were compared between the two groups.Result The mean arterial pressure(MAP)level of two groups were higher than those before and 1 min after the start of pumping 10 min and 30 min after the start of pumping,the differences were statistically significant(P<0.05).30 min after initiation of drug pumping,the systolic blood flow velocity time integral(SVTI),diastolic blood velocity time integral(DVTI)and coronary sinus blood flow(CSBF)levels of patients in two groups were higher than those before drug pumping,the DVTI and CSBF levels of patients in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).30 min after initiation of pumping,stroke output(SV)and left ventricular work done(LVSW)levels in two groups were higher than those before drug pumping,the SV and LVSW levels in research group were higher than those in control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the perioperative study group was 3.08%(2/65),compared with 6.56%(4/61)in the control group,there was no significant difference(P>0.05).Conclusion Compared with norepinephrine,methoxyamine can better maintain stable blood pressure during carotid endarterectomy,increase coronary blood flow and protect cardiac function.

关 键 词：甲氧明 去氧肾上腺素 颈动脉内膜剥脱术 血流动力学 

分 类 号：R543[医药卫生—心血管疾病]