CAJ | 학술논문

目的：观察阿托品预处理在子宫肌瘤剔除术中应用垂体后叶素致心率减慢的预防效果方法选择2012年11~12月内蒙古医科大学附属医院行子宫肌瘤剔除术手术的患者60例,美国麻醉医师协会Ⅰ~Ⅱ级,采用随机数字表法分为生理盐水组和阿托品组,各30例,均采用硬膜外麻醉,于注射垂体后叶素时阿托品组给予阿托品0．4 mg,生理盐水组给予等量生理盐水,分别观察注射前( T0)、注射后2 min( T1)、注射后5 min( T2)、注射后15 min( T3)、注射后25 min( T4)患者心率、收缩压、舒张压的变化,记录高血压及心动过缓的发生率。结果与生理盐水组比较,阿托品组心动过缓的发生率明显降低(0比40．0%)(P<0．01)。其中生理盐水组患者有12例发生心动过缓,阿托品组无一例出现；与T0比较,生理盐水组与阿托品组给予垂体后叶素后收缩压、舒张压均在T1~3时升高(P<0．05),生理盐水组HR在T1~3时明显降低(P<0．05)；阿托品组心率在给垂体后叶素前后无明显变化(P>0．05)。结论预先给予阿托品可有效预防在子宫肌瘤剔除术中应用垂体后叶素致心率减慢。
목적：관찰아탁품예처리재자궁기류척제술중응용수체후협소치심솔감만적예방효과방법선택2012년11~12월내몽고의과대학부속의원행자궁기류척제술수술적환자60례,미국마취의사협회Ⅰ~Ⅱ급,채용수궤수자표법분위생리염수조화아탁품조,각30례,균채용경막외마취,우주사수체후협소시아탁품조급여아탁품0．4 mg,생리염수조급여등량생리염수,분별관찰주사전( T0)、주사후2 min( T1)、주사후5 min( T2)、주사후15 min( T3)、주사후25 min( T4)환자심솔、수축압、서장압적변화,기록고혈압급심동과완적발생솔。결과여생리염수조비교,아탁품조심동과완적발생솔명현강저(0비40．0%)(P<0．01)。기중생리염수조환자유12례발생심동과완,아탁품조무일례출현；여T0비교,생리염수조여아탁품조급여수체후협소후수축압、서장압균재T1~3시승고(P<0．05),생리염수조HR재T1~3시명현강저(P<0．05)；아탁품조심솔재급수체후협소전후무명현변화(P>0．05)。결론예선급여아탁품가유효예방재자궁기류척제술중응용수체후협소치심솔감만。
Objective To observe the preventive effect of atropine pretreatment for pituitrin induced bradycardia in myomectomy. Methods A total of 60 patients who underwent routine myomectomy surgery in Affiliated Hospital of Inner Mongolia,ASA Ⅰ-Ⅱ,during November and December 2012 were divided into two groups by dynamic random grouping method:atropine group ( n=30 ) and saline group ( n =30 ) . The patients all received epidural anesthesia. In atropine group,atropine 0. 4mg was also injected when injecting pituitrin,while saline group was injected normal saline of the same amount. The heart rate(HR),systolic blood pressure( SBP) ,diastolic blood pressure( DBP) before injection( T0 ) ,2 min( T1 ) ,5 min( T2 ) ,15 min ( T3 ) and 25 min( T4 ) after injection were recorded,and the incidence of hypertension and bradycardia was recorded as well. Results Compared with saline group,the incidence of bradycardia was decreased signifi-cantly in atropine group(0 vs 40. 0%)(P<0. 01). There were 12 patients of bradycardia in saline group, and no such case in atropine group. Compared with T0 ,the SBP,DBP of saline group and A at T1-3 were ele-vated(P<0.05),the HR of saline group at T1-3 were significantly decreased (P<0.05);HR of atropine group at T1-4 were not changed(P>0. 05). Conclusion Pretreatment with atropine can effectively prevent pituitrin caused bradycardia in gynecologic surgery.