甲氧明联合麻黄碱甲氧明对老年胃癌全麻后低血压的预防作用研究
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摘要
目的:探讨甲氧明联合麻黄碱甲氧明对老年胃癌全麻后低血压的预防作用研究。方法:选取择期行全麻下腹腔镜胃癌根治术老年患者70例,患者或家属签字同意,按简单随机法分组,对照组35例予以常规诱导,研究组35例全麻诱导阶段静脉注射麻黄碱6mg甲氧明1mg,记录两组患者给药前(T0)和给药后5min(T1)、15min(T2)、30min(T3)时不同时点的生命指标,同时记录麻醉中低血压等不良反应状况。结果:与T0比较,两组患者给药后不同时间点生命体征发生变化,研究组T1、T2、T3时收缩压和舒张压高于对照组,收缩压和舒张压心率低于对照组,具有统计学意义(P<0.05),两组患者不同时间点血氧饱和度无变化,不具有统计学意义(P>0.05);研究组低血压、心动过速发生率(5.71%、8.57%)低于对照组(22.86%、28.57%),差异有统计学意义(P<0.05),两组恶心呕吐、心悸发生率(8.57%、5.71%VS11.43%、14.29%)差异无统计学意义(P>0.05)。结论:采用麻黄碱联合甲氧明应用于老年胃癌全麻能提供稳定的血流动力学状态,低血压发生率低,效果显著。
Objective: To investigate the preventive effects by ephedrine combined with methoxamine in elderly patients with gastric cancer of hypopiesia after general anesthesia. Methods: A total of 70 elderly patients with gastric cancer radical operation by laparoscope after general anesthesia from our hospital,the patients or their families signed an agreement,according to Simple random method was divided into the experiment group and control group with 35 cases in each group. patients in the control group were treated by conventional induction,patients in the experiment group were treated by ephedrine 6 mg and methoxamine 1 mg intravenous drip,induction of general anesthesia stage,recorded the life indexes of the two groups patients before drug administration( T0) and after drug administration 5 min( T1),15 min( T2),30 min( T3),and recorded the adverse reactions of hypopiesia in anesthesia. Results: Compared with T0,the life indexes of the two groups were changed after drug administration,the systolic pressure and diastolic pressure of the experiment group were higher than the control group in T1,T2,T3,systolic pressure and diastolic pressure and heart rate were lower than the control group,with statistical significance( P < 0.05),the blood oxygen saturation of the two groups had no changed at different time points,had no statistical significance( P > 0.05); the hypopiesia and tachycardia incidence rate( 5.71%,8.57%) were lower than the control group( 22.86%,28.57%),the difference was statistical significance( P < 0.05),the nausea,vomiting and palpitation incidence rate of the two groups( 8.57% 5.71% VS11.43% 14.29%) difference had no statistical significance( P > 0.05). Conclusion: Ephedrine combine with methoxamine in the treatment of elderly patients with gastric cancer after general anesthesia can provide a stable hemodynamic state,low incidence rate of hypopiesia,the effect is remarkable.
Objective: To investigate the preventive effects by ephedrine combined with methoxamine in elderly patients with gastric cancer of hypopiesia after general anesthesia. Methods: A total of 70 elderly patients with gastric cancer radical operation by laparoscope after general anesthesia from our hospital,the patients or their families signed an agreement,according to Simple random method was divided into the experiment group and control group with 35 cases in each group. patients in the control group were treated by conventional induction,patients in the experiment group were treated by ephedrine 6 mg and methoxamine 1 mg intravenous drip,induction of general anesthesia stage,recorded the life indexes of the two groups patients before drug administration( T0) and after drug administration 5 min( T1),15 min( T2),30 min( T3),and recorded the adverse reactions of hypopiesia in anesthesia. Results: Compared with T0,the life indexes of the two groups were changed after drug administration,the systolic pressure and diastolic pressure of the experiment group were higher than the control group in T1,T2,T3,systolic pressure and diastolic pressure and heart rate were lower than the control group,with statistical significance( P < 0.05),the blood oxygen saturation of the two groups had no changed at different time points,had no statistical significance( P > 0.05); the hypopiesia and tachycardia incidence rate( 5.71%,8.57%) were lower than the control group( 22.86%,28.57%),the difference was statistical significance( P < 0.05),the nausea,vomiting and palpitation incidence rate of the two groups( 8.57% 5.71% VS11.43% 14.29%) difference had no statistical significance( P > 0.05). Conclusion: Ephedrine combine with methoxamine in the treatment of elderly patients with gastric cancer after general anesthesia can provide a stable hemodynamic state,low incidence rate of hypopiesia,the effect is remarkable.
引文
[1]刘聚堂.硬膜外阻滞对老年胃癌全身麻醉下根治术后患者认知的影响[J].中国当代医药,2014,21(27):90~92.
[2]李中巧.麻黄素和甲氧明在预防全麻诱导期低血压中的效果比较[J].中国社区医师:医学专业,2012,14(9):164.
[3]杨刚,宋世姣,尹静,等.甲氧明防治老年患者下肢骨科手术蛛网膜下腔阻滞后低血压的临床研究[J].重庆医学,2015,44(17):2359~2361.
[4]王旭莉,郭志华,赵伟.预注适量甲氧明或麻黄碱对全麻诱导期低血压的防治[J].中国医学创新,2014,11(6):109~110.
[5]周德祥,熊双宝,熊雄.甲氧明联合阿托品预防老年患者全麻诱导期低血压的临床观察[J].海南医学院学报,2012,18(9):2864~2866.
[6]陈晓.采用复合方法对全麻复合硬膜外麻醉行胃癌根治术病人诱导期低血压的防治效果[D].山东大学,2015.
[7]尚跃宏,高振意,翁绳凤,等.预注甲氧明预防老年患者腰硬联合麻醉后低血压的临床观察[J].北京医学,2014,36(8):643~645.
[8]胡艳.预注甲氧明对剖宫产患者腰-硬联合麻醉术中低血压的防治效果[J].中国药物经济学,2015,(12):48~50.
[9]Simin A,Zahra F,Pouya H M,et al.Comparison the effect of ephedrine and phenylephrine in treatment of hypotension after spinal anesthesia during cesarean section[J].Pharmacological Research the Official Journal of the Italian Pharmacological Society,2014,83(4):91~94.
[10]周志泽.甲氧明联合阿托品预防老年患者全麻诱导期低血压的临床观察[J].国际医药卫生导报,2013,19(18):2864~2866.
[11]章明勇.甲氧明与麻黄碱预注射对老年患者肌松效果及生命体征的影响[J].中华全科医学,2015,13(1):148~149.
[12]甘美勤.预注甲氧明在腰硬联合麻醉中防治低血压的临床观察[J].中国实用医刊,2013,40(21):122.
[13]牛犇,田玉科.甲氧明联合麻黄碱预防剖宫产脊麻后低血压作用研究[J].医药导报,2011,30(10):1304~1307.
[14]冯亮群.不同药物联合甲氧明对预防腰麻剖宫产患者低血压及不良反应的效果比较[J].中国现代药物应用,2015,9(17):152~153.
[2]李中巧.麻黄素和甲氧明在预防全麻诱导期低血压中的效果比较[J].中国社区医师:医学专业,2012,14(9):164.
[3]杨刚,宋世姣,尹静,等.甲氧明防治老年患者下肢骨科手术蛛网膜下腔阻滞后低血压的临床研究[J].重庆医学,2015,44(17):2359~2361.
[4]王旭莉,郭志华,赵伟.预注适量甲氧明或麻黄碱对全麻诱导期低血压的防治[J].中国医学创新,2014,11(6):109~110.
[5]周德祥,熊双宝,熊雄.甲氧明联合阿托品预防老年患者全麻诱导期低血压的临床观察[J].海南医学院学报,2012,18(9):2864~2866.
[6]陈晓.采用复合方法对全麻复合硬膜外麻醉行胃癌根治术病人诱导期低血压的防治效果[D].山东大学,2015.
[7]尚跃宏,高振意,翁绳凤,等.预注甲氧明预防老年患者腰硬联合麻醉后低血压的临床观察[J].北京医学,2014,36(8):643~645.
[8]胡艳.预注甲氧明对剖宫产患者腰-硬联合麻醉术中低血压的防治效果[J].中国药物经济学,2015,(12):48~50.
[9]Simin A,Zahra F,Pouya H M,et al.Comparison the effect of ephedrine and phenylephrine in treatment of hypotension after spinal anesthesia during cesarean section[J].Pharmacological Research the Official Journal of the Italian Pharmacological Society,2014,83(4):91~94.
[10]周志泽.甲氧明联合阿托品预防老年患者全麻诱导期低血压的临床观察[J].国际医药卫生导报,2013,19(18):2864~2866.
[11]章明勇.甲氧明与麻黄碱预注射对老年患者肌松效果及生命体征的影响[J].中华全科医学,2015,13(1):148~149.
[12]甘美勤.预注甲氧明在腰硬联合麻醉中防治低血压的临床观察[J].中国实用医刊,2013,40(21):122.
[13]牛犇,田玉科.甲氧明联合麻黄碱预防剖宫产脊麻后低血压作用研究[J].医药导报,2011,30(10):1304~1307.
[14]冯亮群.不同药物联合甲氧明对预防腰麻剖宫产患者低血压及不良反应的效果比较[J].中国现代药物应用,2015,9(17):152~153.