三磷酸腺苷预防气管拔管时心血管反应的临床观察

Clinical observations on effects of adenosini triphosphas on preventing cardiovascular response in extubation

目的：观察三磷酸腺苷对全麻苏醒拔管期病人的心血管的影响。方法：选择ASAⅠ-Ⅱ级全麻手术病人40例,随机分为观察组（n=20）和对照组（n=20）,观察组于术毕拔管前5min缓慢静注三磷酸腺苷0.3mg/kg,对照组拔管时不用任何药物,记录拔管前5min、拔管时、拔后1、3、6min各时点的SBP、DBP、HR、MAP,并计算出RPP。结果：观察组在拔管时、拔管后1min和3min各项指标明显低于对照组（P〈0.01或0.05）,但两组在拔管前5min、拔管后6min各项指标相比无明显差异（P〉0.05）。结论：0.3mg/kg三磷酸腺苷可有效地预防全麻手术苏醒拔管期的心血管反应。

Objective： To observe the effects of adenosini triphosphas （ATP） on prevention of cardiovascular resouse to endotracheal extubadon when a patient came to his consciousness from general anesthesia. Methods： Forty patients（ASA Ⅰ to Ⅱ ） undergone general anesthesia were randomly allocated to observation and control group with 20 in each. Observation group were given intravenous drip with adenosini triphosphas at a dose of 0.3 mg/kg 5 rain prior to extubation, whereas control group received no medication. Systolic blood pressure（SBP）, diastohe blood pressure（DBP）, heart rate（HR） and mean arterial pressure （MAP） were recorded 5 rain before extubation, during extubation, at 1 min, 3 rain and 6 rain after extubation, respectively, and RPP was determined. Results ： All indexes were significantly decreased during extubation, at 1 rain and 3 rain after extubation compared with control group （p〈0.01 or 0.05）. But the indexes between observation group and control group showed no striking difference at 5 rain before extubation and 6 rain following extubation. Conclusion ： Administration of adenosi- ni triphosphas at a dose of 0.3 mg/kg can prevent patients from cardiovascular response when patients are in condition of palinesthesia.