CAJ | 학술논문

目的探讨艾司洛尔对颈丛阻滞下心肌缺血患者的应用价值. 方法 40例患者随机分为对照组(A)和艾司洛尔组(B),每组20例.B组于阻滞实施同时先静脉注射艾司洛尔0.4 mg/kg,后以5 mg·kg~(-1)·h~(-1)的速度持续静脉输注.记录颈丛阻滞前、阻滞完毕时及用药后10 min、30 min血流动力学指标、心电图变化和不良反应. 结果 A组(对照组)MAP、HR、RPP在阻滞结束时、阻滞后10、30 min与阻滞前差异有统计学意义(P<0.01);B组MAP、HR、RPP在以上各时段与阻滞前比较差异均无统计学意义(P>0.05);两组阻滞后各时段的对应参数比较差异均有统计学意义(P<0.01).A组用药后10、30 min S-T段下移幅度增加有统计学意义(P<0.05),而B组用药后10、30 min S-T段下移幅度减小,亦有统计学意义(P<0.05);两组阻滞后各时段的s-T段下移幅度差异均有统计学意义(P<0.05或P<0.01).B组阻滞后心悸、头痛的发生率明显增加,与A组比较差异均有统计学意义(P<0.05). 结论艾司洛尔用于心肌缺血患者的颈丛阻滞时能有效地降低心肌氧耗、改善心肌氧供、减少不良反应的发生率.
목적 탐토애사락이대경총조체하심기결혈환자적응용개치. 방법 40례환자수궤분위대조조(A)화애사락이조(B),매조20례.B조우조체실시동시선정맥주사애사락이0.4 mg/kg,후이5 mg·kg~(-1)·h~(-1)적속도지속정맥수주.기록경총조체전、조체완필시급용약후10 min、30 min혈류동역학지표、심전도변화화불량반응. 결과 A조(대조조)MAP、HR、RPP재조체결속시、조체후10、30 min여조체전차이유통계학의의(P<0.01);B조MAP、HR、RPP재이상각시단여조체전비교차이균무통계학의의(P>0.05);량조조체후각시단적대응삼수비교차이균유통계학의의(P<0.01).A조용약후10、30 min S-T단하이폭도증가유통계학의의(P<0.05),이B조용약후10、30 min S-T단하이폭도감소,역유통계학의의(P<0.05);량조조체후각시단적s-T단하이폭도차이균유통계학의의(P<0.05혹P<0.01).B조조체후심계、두통적발생솔명현증가,여A조비교차이균유통계학의의(P<0.05). 결론 애사락이용우심기결혈환자적경총조체시능유효지강저심기양모、개선심기양공、감소불량반응적발생솔.
Objective To observe the effects of esmolol on patients with myocardial isehemia during cervical plexus block.Methods Forty patients were randomly divided into two groups:the control group(group A),the esmolol group(group B).Each group include 20 cases.Group B received mainline of esmolol 0.4mg/kg(initial dose)and continue infused at a rate of 5mg·kg~(-1)·h~(-1),and group A received normal saline as control.Various irculation function monitoring indexes,change of electrocardiogram and adverse reaction before block,at the end of block and 0min,30min after cervical plexus block were recorded.Results In group A,MAP,HR and RPP were significantly decreased at the end of block and 10min,30min after cervical plexus block compared with before block(P<0.01).But in group B,MAP,HR and RPP were not changed significantly than that before block(P>0.05);comparing the two groups,the corresponding parameter was significantly different at each time after block(P<0.01).In group A,the downward shift distance of S-T section was significantly increased at each time after block than that before block (P<0.05),but in group B,that was significantly decreased(P<0.05);comparing the two groups,the corresponding downward shift distance of S-T section was significantly different at each time after block(P<0.01).The group B have higher proportion of palpitation,headache than that of group A,the difference was significant.Conclusion Esmolol has protective effects in lessening myocardial oxygen consumption,improving myocardial blood oxygen supply and reducing proportion of adverse reaction on patients with myocardial ischcmia.