摘要
目的:观察选择性M-受体拮抗剂长托宁对二尖瓣置换术患者血液动力学及胃粘膜pH值(i-pH)的影响。方法:选择二尖瓣置换手术30例,随机分为两组,长托宁组(C组)和东莨菪碱组(D组),分别于麻醉诱导前30min肌肉注射C组长托宁0.015mg/kg和D组东莨菪碱0.006mg/kg,记录患者在给药前(T0),给药后10min(T1),给药后30min(T2)的心率和血压的变化以及给药前(T0),给药后30min(T2),转机后10min(T3),转机后30min(T4)以及停机时(T5)对应点动脉血pH值(pHa),动脉血二氧化碳分压(PCO2),胃黏膜的pH值(i-pH)。结果:给药后与基础值相比,D组心率明显增快(P<0.05),但血压基本平稳;C组用药后心率、血压与基础值相比明显下降(P<0.05);C组用药后心率、血压明显低于D组(P<0.05);两组pHa、i-pH在T2、T3、T4、T5时明显下降(P<0.05或P<0.01),但D组比C组下降更明显(P<0.05)。结论:长托宁对二尖瓣置换术患者的血液动力学影响小于东莨菪碱,并且可以改善微循环灌注。
Objective： To evaluate the effect of penehyclidine hydrocbloride （selective Mcholinoceptor antagonist） on hemodynamics and i-pH of patients of replacement of mitral valve, Methods ： 30 cases of replacement of mitral valve were randomly divided into 2 groups. In penehyclidine hydrochloride group （group C）, penehyclidine hydrochloride was injected with 0. 015mg/kg 30 min before induction. In scopolamine group （group D）, the dose of scopolamine was 0. 006mg/kg. The changes of HR, BP were recorded before （T0）, 10 min after（T1） and 30 min after（T2） administration. At the sarne time, pHa, PCO2 and i-pH were recorded at To, T2, 10 min after （T3）, 30 min after extracorporeal circulation （T4） and in the end of extracorporeal circulation（T5） respectively. Results： In group D, HR increased obviously after administration （P 〈0.05）, but BP didn＇t change greatly. In group C, HR and BP both decreased obviously after administration （P 〈0.05）, HR and BP in group C were lower than those in group D （P 〈0.05）. pHa and i-pH at T2, T3,T4 and T5 decreased in both groups and the change in group D was more obvious （P〈0. 05）. Conclusion： The effect of penehyclidine pydrochloride on hemodynamics of patients of replacement of mitral valve was less than scopolamine and penehyclidine hydrochloride could improve perfusion of microdrculation.
出处
《陕西医学杂志》
CAS
北大核心
2006年第9期1147-1149,1178,共4页
Shaanxi Medical Journal
