摘要
【目的】观察参麦注射液对全凭静脉麻醉手术的高龄冠心病患者心功能指标的影响,寻找预防手术麻醉对心功能影响的有效药物。【方法】将104例择期行腹部手术的80岁以上高龄冠心病患者随机分为观察组和对照组各52例,全部病例均采用全凭静脉麻醉,观察组于手术开始前将参麦注射液20 mL加入9 g/L氯化钠注射液50 mL中静脉注射,然后再将参麦注射液40 mL加入50 g/L葡萄糖注射液500 mL中静脉滴注。对照组给予50 g/L葡萄糖注射液500 mL静脉滴注。监测手术前后血液动力学指标,左室射血分数(EF)、短轴缩短率(△D%)、室壁增厚率(△T%)、左室舒张早期快速充盈峰值流速(Emax)、左房收缩期血流峰值流速(Amax)等心功能指标,以及血浆脑钠素(BNP)、血浆N-末端脑钠肽前体(NTproBNP)水平的变化。【结果】观察组血液动力学指标稳定(P>0.05),心功能指标参数改善(P<0.05),血浆BNP、NTproBNP水平较术前均有明显下降(P<0.01);对照组血液动力学指标波动较大,心功能指标参数变差(P<0.05),血浆BNP、NT-proBNP水平反而上升(P<0.05)。2组比较,术后心功能指标参数、血浆BNP、NT-proBNP水平差异均有统计学意义(P<0.01)。【结论】参麦注射液能够稳定和改善血液动力学指标,改善心功能指标参数,降低血浆BNP、NT-proBNP水平,对全凭静脉麻醉手术的高龄冠心病患者的心功能有良好的保护作用。
Objective To observe the effect of Shenmai Injection on cardiac function of elderly coronary heart disease patients receiving operation under intravenous anesthesia, and to search for an effective drug for preventing operative anesthesia damage on cardiac function. Methods One hundred and four coronary heart disease patients over 80 years old who would receive elective abdominal operation were evenly randomized into observation group and control group. All of the patients received the abdominal operation under intravenous anesthesia. Before treatment, the observation group was given intravenous injection of Shenmai Injection 20 mL＋ 9 g/L Sodium Chloride Injection 50 mL, and then given intravenous drip of Shenmai Injection 40 mL＋ 50 g/LGlucose Injection 500 mL, and the control group was given intravenous drip of 50 g/L Glucose Injection 500 mL. Hemodynamics indexes, and cardiac function parameters such as left ventricular ejection fraction （EF）, shortening fraction （AD%）, wall thickening rate （AT%）, left ventricular early diastolic rapid filling wave peak flow rate （Emax） and left atrial systolic blood flow peak flow rate （Amax） were monitored before and after being treated with total intravenous anesthesia. The changes of the plasma levels of brain natriuretie peptide （BNP） and N-terminal pro-brain natriuretic peptide （NT-proBNP） were monitored during the operation. Results In the observation group, hemodynamics indexes were stable （P〉0.05） , heart function parameters were improved （P〈0.05）, and plasma BNP and NT-proBNP levels were significantly decreased （P〈0.01） as compared with those before operation. In the control group, the hemodynamics indexes fluctuated, heart function parameters became aggravation （P〈0.05） , and plasma BNP and NT-proBNP levels were increased （P〈0.05） . The differences of heart function parameters and plasma BNP and NT-proBNP levels were significant between the two groups after operation （P〈0.01） . Conclusion Shenmai Injection has an effect on stabilizing and improving hemodynamics indexes, improving heart function parameters, and decreasing plasma BNP and NT-proBNP levels, thus to protect heart function of elderly coronary heart disease patients receiving operation under intravenous anesthesia.
出处
《广州中医药大学学报》
CAS
北大核心
2014年第2期178-182,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
佛山市科技局医学类科技攻关项目(编号:201308070)
关键词
参麦注射液
全凭静脉麻醉
高龄患者
冠心病
心功能
Shenmai Injection
Total intravenous anesthesia
Elderly patients
Coronary heart disease
Heart function
