中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
11期
1040-1041
,共2页
拉贝洛尔%内窥镜检查%降压,控制性
拉貝洛爾%內窺鏡檢查%降壓,控製性
랍패락이%내규경검사%강압,공제성
Labetalol%Endoseop%Hypotension,controlled
目的 评价拉贝洛尔控制性降压在鼻内镜手术中的应用效果. 方法 择期行功能性鼻内镜鼻窦手术(FESS)术的成年患者50例,美国麻醉医师协会分组Ⅰ～Ⅱ级,年龄20～65岁,体重42～80 kg,完全随机分为2组,均选用气管内插管静脉吸入复合全身麻醉.对照组未用控制性降压,拉贝洛尔组经微泵静脉注射拉贝洛尔,使患者平均动脉压下降25%左右,监测心电图、心率、平均动脉压.记录手术时间,手术出血量.记录术毕清醒时间及麻醉前(T0)、降压开始30 min(T1)、降压结束20 min(T2)三个时点的心率、平均动脉压,并进行统计分析. 结果 拉贝洛尔组能按预定目标降到需要的血压值[T1时达到(67±7)mm Hg(1 mm Hg=0.133 kPa)],与对照组[T1时达到(84±10)mm Hg]相比差异有统计学意义(P＜0.01),且手术时间和出血量[分别为(131.2±30.5)min,(107.3±29.2)m1]均明显少于对照组[分别为(173.6±18.3)min,(230.2±36.4)ml](均P＜0.05),术毕清醒时间2组差异无统计学意义(均P＞0.05). 结论 拉贝洛尔控制性降压应用于鼻内镜手术安全有效且能明显减少术中出血量和手术时间.
目的 評價拉貝洛爾控製性降壓在鼻內鏡手術中的應用效果. 方法 擇期行功能性鼻內鏡鼻竇手術(FESS)術的成年患者50例,美國痳醉醫師協會分組Ⅰ～Ⅱ級,年齡20～65歲,體重42～80 kg,完全隨機分為2組,均選用氣管內插管靜脈吸入複閤全身痳醉.對照組未用控製性降壓,拉貝洛爾組經微泵靜脈註射拉貝洛爾,使患者平均動脈壓下降25%左右,鑑測心電圖、心率、平均動脈壓.記錄手術時間,手術齣血量.記錄術畢清醒時間及痳醉前(T0)、降壓開始30 min(T1)、降壓結束20 min(T2)三箇時點的心率、平均動脈壓,併進行統計分析. 結果 拉貝洛爾組能按預定目標降到需要的血壓值[T1時達到(67±7)mm Hg(1 mm Hg=0.133 kPa)],與對照組[T1時達到(84±10)mm Hg]相比差異有統計學意義(P＜0.01),且手術時間和齣血量[分彆為(131.2±30.5)min,(107.3±29.2)m1]均明顯少于對照組[分彆為(173.6±18.3)min,(230.2±36.4)ml](均P＜0.05),術畢清醒時間2組差異無統計學意義(均P＞0.05). 結論 拉貝洛爾控製性降壓應用于鼻內鏡手術安全有效且能明顯減少術中齣血量和手術時間.
목적 평개랍패락이공제성강압재비내경수술중적응용효과. 방법 택기행공능성비내경비두수술(FESS)술적성년환자50례,미국마취의사협회분조Ⅰ～Ⅱ급,년령20～65세,체중42～80 kg,완전수궤분위2조,균선용기관내삽관정맥흡입복합전신마취.대조조미용공제성강압,랍패락이조경미빙정맥주사랍패락이,사환자평균동맥압하강25%좌우,감측심전도、심솔、평균동맥압.기록수술시간,수술출혈량.기록술필청성시간급마취전(T0)、강압개시30 min(T1)、강압결속20 min(T2)삼개시점적심솔、평균동맥압,병진행통계분석. 결과 랍패락이조능안예정목표강도수요적혈압치[T1시체도(67±7)mm Hg(1 mm Hg=0.133 kPa)],여대조조[T1시체도(84±10)mm Hg]상비차이유통계학의의(P＜0.01),차수술시간화출혈량[분별위(131.2±30.5)min,(107.3±29.2)m1]균명현소우대조조[분별위(173.6±18.3)min,(230.2±36.4)ml](균P＜0.05),술필청성시간2조차이무통계학의의(균P＞0.05). 결론 랍패락이공제성강압응용우비내경수술안전유효차능명현감소술중출혈량화수술시간.
Objective To evaluate the effect of controlled hypotension in functional endoscopic sinus surgery with Labetalol. Methods Totally 50 patients(ASAⅠ～Ⅱ class aged 20 ～65 yr weighing 42 ～ 80 kg)were scheduled for functional endoscopic sinus surgery(FESS)and were randomly divided into two groups.All patients had endotracheal intubation inhalation compound venous anesthesia.Patients in control group hadn't accepted controlled hypotension.Patients in labetalol group accepted intravenous injection of labetalol,which makes their mean atrial pressure(MAP)decreased about 25%.All patients' electrocardiograph,heart rate and MAP were monitored.Awake time of each patient was recorded.Heart rate and MAP at T0(preanethesia),T1(30 minutes after initiation of controlled hypotension)and T2(20 minutes after the end of controlled hypotension)were recorded and analyzed. Results MAP of the patients in Group B can be reduced according to the needs of target(P ＜ 0.01).The operation time and bleeding volume were less than the patients in group A(P ＜ 0.05),but the recovery time after surgery had no significant difference between the two groups(P ＞ 0.05). Conclusion It is safe and effective to use controlled hypotension in endoscopic sinus surgery with Labetalol and it can significantly reduce blood loss and operative time.
