摘要
目的比较盐酸戊乙奎醚与东莨菪碱作为肿瘤全身热化疗术前用药对心率、术后72h内谵妄发生率等的影响。方法选择拟行肿瘤全身热化疗的中青年患者60例,随机分为A、B两组,每组各30例。A组患者术前肌内注射东莨菪碱0.3 mg,术中根据出汗情况决定是否追加药物;B组患者术前肌内注射盐酸戊乙奎醚1 mg,术中根据出汗情况决定是否追加药物。观察两组患者体温升至41.8℃的时间,升温至39、41.8℃及复温至39℃时的心率,记录术后72h内谵妄发生率。结果 A组患者升温期均出汗明显,影响升温速度,静脉追加东莨菪碱0.3 mg。B组患者升温期不出汗或者轻微出汗,不影响升温速度,均不需要追加药物。两组患者升温时间差异无统计学意义(P>0.05)。升温至39、41.8℃时,A组患者心率明显较B组快(P<0.01)。A组中有14例(占46.7%)患者术后72h内发生谵妄,明显多于B组(4例,占13.3%)(P<0.01)。结论盐酸戊乙奎醚一次肌内注射1 mg时,即能达到东莨菪碱2次用药(每次0.3 mg)的效能,并且能够减缓升温期及恒温期的心率,减少术后72h内谵妄的发生率,更适合应用于肿瘤全身热化疗患者。
Objective To compare the influence of penehyclidine hydrochloride and scopolamine on heart rate and incidence rate of delirium with in 72 hours after srugery in tumour whole body hyperthermia. Methods 60 cases of young patients scheduled for whole bode hyperthermia operation under general anesthesia were randomly assigned into group A（30 cases） and group B（30 cases）.Group A was premedicated with scopolamine（0.3 mg） intramuscular injection before anesthesia,and whether given more medicine according to the sweating during the operation.Group B received penehyclidine （1 mg） intramuscular injection before anesthesia,and if or not received more medicine according to the sweating during the operation.Time to rise to 41.8℃,heart rate（HR） at 39℃,41.8℃ and recovery to 39℃ were compared between the two groups.The rate of delirium was also recorded. Results Obvious sweat was found and scopolamine（0.3 mg） was injected during operation in group A,but sweat was not found or was slight which cann＇t affect the time of operation in group B.There wasn＇t significant difference in time of rising temperature between the two groups.HR significantly increased in group A at 39℃ and 41.8℃（P〈0.01）.Delirium occurred in 15 patients in group A （accounted for 46.7%）,which were significantly more than that of group B （4 patients,accounted for 13.3%）（P〈0.01）. Conclusion Penehyclidine hydrochloride（1 mg） intramuscular injected before anesthesia once was equal to scopolamine（0.3 mg） injected twice during the operation.Compared with scopolamine,penehyclidine can decrease HR,reduce the incidence rate of delirium,and was more suitable in whole body hyperthermia.
出处
《中国当代医药》
2013年第30期87-89,共3页
China Modern Medicine
关键词
盐酸戊乙奎醚
全身热疗
心率
谵妄+
Penehyclidine hydrochloride
Whole body hyperthermia
Heart rate
Delirium
