围术期使用盐酸戊乙奎醚减少开胸手术患者术后肺不张的发生

Clinical study of atelectasis following thoracotomy by penehyclidine hydrochloride

目的探讨围术期间使用盐酸戊乙奎醚预防开胸手术后肺不张的可行性及临床效果。方法152例择期或限期普胸手术（肺、食管手术），患者随机分为盐酸戊乙奎醚组和对照组，各76例。盐酸戊乙奎醚组于术前、术后1-4d分别肌肉注射盐酸戊乙奎醚13．7μg／kg（最大量不超过1．0mg），对照组仅术前给常规剂量东莨菪碱。记录2组术中血流动力学参数心率（HIK）、收缩压（SBP）、舒张压（DBP）的变化，并记录2组术中吸引量和术后咳痰量及2组肺不张发生例数。结果2组术中血流动力学指标差异无显著性，P〉0．05；盐酸戊乙奎醚组术中吸引量、术后痰量和对照组比较差异有显著性，P〈0．05；肺不张发生例数实验组0例，对照组3例，2组比较差异有显著性，P〈0．01。结论围术期间使用盐酸戊乙奎醚能明显减少开胸手术患者术后肺不张的发生，但其剂量、疗程需做进一步研究。

[Objective] To investigate the preventive effect of atelectasis following thoracotomy by penehyclidine hydrochloride. [Methods] One hundred and fifty-two patients receiving selective operation or limited operation of chest （lung, esophagus） surgery were divided randomly into two groups with 76 patients each： penehyclidine hydroehloride group（group A） and control group（group B）. Group A was given penehyclidine hydrochloride 13.7μg/kg by intramuscular injection in preoperative and postoperative 1-4 days; group B was given scopolamine of conventional dosage. The hemodynamie parameters including HR, SBP, DBP, the volume dose of aspirate sputum in operation, the volume dose of begma postoperative and the quantity of two groups postoperative atelectasis were noted. [Results] There were no significant differences between two groups in the hemodynamic parameters （P 〉0.05）.The volume dose of sputum in group A was lower than that in group B （P 〈0.05）. None in group A while 3 in group B was of postoperative atelectasis, there were significant differences between two groups in the quantity of postoperative ateleetasis （P 〈0.01）. [Conclusion] Penehyclidine hydrochloride preventing atelectasis following thoracotomy is safe and effective, but to the dosage and course of treatment of drug we need study any further.