麻黄碱预防鱼精蛋白不良反应的临床观察

Clinical observation on precaution effect of ephedrine on protamine＇s untoward reaction

目的探讨麻黄碱预防硫酸鱼精蛋白不良反应的作用。方法择期左房室瓣瓣膜置换术患者40例随机分为麻黄碱组（A组）、对照组（B组），每组20例。术中以5％葡萄糖注射液稀释硫酸鱼精蛋白至50ml配成中和液中和肝素，A组中和液中加入麻黄碱3mg，B组不加，两组中和液均经颈内静脉在5min滴完。观察两组注药前及后1、3、5、10min的血压、心率、气道压力及血氧饱和度变化。结果A组注药前后血压、心率、气道压力变化差异无统计学意义（P〉0．05）；B组有6例注药后出现血压、心率明显下降，气道压上升（P〈0．05）。结论麻黄碱能明显减少或缓解硫酸鱼精蛋白中和肝素所引起的不良反应。

Objective To investigate precaution effect of ephedrine on protamine＇s untoward reaction. Methotis Forty patients,who were scheduled to have mitral valve replacement operation were randomly divided into two groups ： ephedrine group（ group A, n = 20 ） and control group （ group B, n = 20 ）. 50ml solution, mixed with protamine and 5% glueose ,was injected through internal jugular vein in five minutes to neutralize the effect of heparin. In group A,3mg ephedrine was added into neutralization solution while in group B nothing was added. Arterial pressure（ AP）, heart rate（HR） peripheral hemoglobin oxygen saturation （SpO2 ） and airway resistance （AR） were measured before injection and 1,3,5,10 minutes after injection in both groups. Results In group A,the AP,HR,SpO2 and AR had no signifieant differenee before and after injeetion（P 〉0.05） ;while in 6 eases of group B,the AP,HR,SpO2 and AR have significant difference before and after injection. Conclusion Ephedrine can significantly improve protamine＇s untoward reaction, and neutralize the effect of heparin.