摘要
目的评估盐酸甲氧明对复合麻醉下行开胸肺叶切除术中血流动力学的影响。方法拟于全身麻醉复合硬膜外麻醉下行开胸肺叶切除术患者60例,随机分为甲氧明持续输注组与甲氧明单次推注组,每组30例。甲氧明持续输注组在气管插管后盐酸甲氧明2μg/(kg·min)持续输注,当发生低血压时单次静脉注射甲氧明1 mg。甲氧明单次推注组在气管插管后,患者出现低血压时缓慢(30 s内)静注盐酸甲氧明1 mg。记录并比较两组患者心血管不良事件的发生例数。结果甲氧明持续输注组低血压(16.67%)、心动过缓(20.00%)的发生率低于甲氧明单次推注组(73.3%,53.3%),差异有显著性(P<0.05)。两组高血压(40.00%vs.46.67%)和心动过速(43.33%vs.40.00%)发生率无显著差异(P>0.05)。结论盐酸甲氧明持续泵注能有效降低全麻复合硬膜外麻醉下开胸肺叶切除术患者低血压及心动过缓的发生率。
Objective To evaluate the effect of methoxamine on hemodynamics in patients undergoing thoracic lobectomy under general anesthesia combined epidural anesthesia. Methods A total of 60 elderly patients undergoing thoracic lobectomy under general anesthesia combined epidural anesthesia were randomly divided into continuous infusion of methoxamine group and single injection of methoxamine group,30 cases in each group. Patients in continuous infusion of methoxamine group were treated with continuous infusion of methoxamine at 2 μg/（ kg ·min）,and slowly intravenous injection of 1 mg methoxamine（ within 30 seconds） in patients with hypotension. Patients in single injection of methoxamine group were treated with slowly intravenous injection of 1 mg methoxamine（ within 30 seconds） in patients with hypotension. The incidence of adverse cardiovascular events in patients had been recorded and compared. Results The incidence rates of patients with hypotension and bradycardia in continuous infusion of methoxamine group were 16. 67% and 20. 00%,they were significantly lower than those of patients in single injection of methoxamine group（ 73. 3% and 53. 3%）（ P〈0. 05）. There was no significant difference in the incidence of hypertension（ 40. 00%vs. 46. 67%） and tachycardia（ 43. 33% vs. 40. 00%） between the two groups（ P〉0. 05）. Conclusion Methoxamine can reduce the incidence of hypotension and bradycardia in patients undergoing thoracic lobectomy with general anesthesia combined epidural anesthesia.
作者
张凌
万磊
丁冠男
ZHANG Ling WAN Lei DING Guan - nan(Department of Anesthesiology, Beijing Youlian ENT Hospital, Beijing 100122, China Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.)
出处
《临床和实验医学杂志》
2017年第9期922-924,共3页
Journal of Clinical and Experimental Medicine
