摘要
目的评价多索茶碱对全麻机械通气下慢性阻塞性肺疾病(COPD)患者呼吸动力学的影响。方法选择全麻下行下腹部手术的COPD患者120例,随机为三组:对照组(A组,氯化钠注射液)、多索茶碱组(B组,多索茶碱4 mg·kg^(-1))、地塞米松+多索茶碱组(C组,地塞米松5 mg+多索茶碱4 mg·kg^(-1)),每组40例。三组麻醉诱导方式相同,诱导后5 min,三组均用电子微泵静脉注射药物,25 min内完成。麻醉维持方式相同,记录给药即刻(T_1),给药后30 min(T_2)、45 min(T_3)和60 min(T_4)时的呼吸动力学及动脉血气分析指标,并观察不良反应。结果三组T_1时呼吸动力学及血气分析指标均无显著差异(P>0.05)。T_2~T_4各时点B组和C组气道峰压、气道平台压、气道阻力及动脉二氧化碳分压均低于A组(P<0.05),肺顺应性和动脉氧分压高于A组(P<0.05),B组与C组间比较均无显著差异(P>0.05)。A组出现支气管痉挛4例,C组出现1例,B组未见。结论多索茶碱可以有效提高全麻机械通气下手术的COPD患者的胸肺顺应性,改善患者的通气功能和缺氧状态。
AIM To evaluate the effects of doxophylline （Dox） on pneodynamics of mechanically ventilated patients with chronic obstructive pulmonary disease （COPD） under general anesthesia. METHODS One hundred and twenty COPD patients undergoing lower abdominal surgery with general anesthesia were selected and divided into three groups randomly （n = 40） ： control group （group A, with sodium chloride injection 50 mL）, Dox group （group B, with Dox 4 mg·kg-1） and dexamethasone （Dex） ＋ Dox group （group C, with Dex 5 mg and Dox 4 mg·kg-1） . The anesthesia induction and maintenance were performed under the same protocols in the three groups. Five minutes after intravenous induction of general anesthesia, intravenous injection in all groups was applied by electronic micro-pump in 25 minutes. The pneodynamics parameters and indexes of blood gas analysis were monitored at different time points, including administration （T1） and 30 minutes （T2）, 45 minutes （T3）, 60 minutes （T4） after administration. The adverse reactions were recorded. RESULTS There were no statistical difference in pneodynamics parameters and indexes of blood gas analysis among three groups at TI （P 〉 0.05） . The levels of peak airway pressure, plateau airway pressure, airway resistance and PaCO2 in the group B and C were lower than those in the group A at T2 to T4, but lung compliance and PaO2 were higher （P 〈 0.05） comparing to the group A. Four patients developed bronchospasm in the group A and one in the group C. CONCLUSION Dox can increase chest-lung compliance, enhance ventilatory function, correct anerobic condition in COPD patients undergoing mechanical ventilation with general anesthesia.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2013年第11期900-903,共4页
Chinese Journal of New Drugs and Clinical Remedies
关键词
多索茶碱
肺疾病
慢性阻塞性
麻醉
全身
呼吸动力学
doxofylline
pulmonary disease, chronic obstructive
anesthesia, general
pneodynamics [
