OSAHS患者术后监护及长托宁的干预作用

Postoperative Care and Intervention of Penehyclidine Hydrochloride Injection in Obstructive Sleep Apnea-hypopnea Syndrome.

目的对重症医学科(intensive care unit,ICU)内阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者术后进行监护并观察盐酸戊乙奎醚(长托宁)的干预作用。方法将行腭垂腭咽成形术的OSAHS患者45例,年龄在35～50岁,美国麻醉医师学会(ASA)分级Ⅰ级,BMI在30.3±2.6kg/m2,AHI在28.2±2.8次/小时,术后入重症医学科,随机分为3组:阿托品0.5mg(A组)、长托宁0.5mg(B组)及注射用水1ml(C组),记录用药后患者生命体征及气管导管内分泌物量的变化。结果 3组用药前的MAP、HR差异均无统计学意义(P均>0.05),B组与A组、C两组相比较,用药后各时间点的MAP、HR的差异有统计学意义(P均<0.05)。A、B组用药后各时间段内气管导管内分泌物的累计量均少于C组(P均<0.01)。结论长托宁明显减少气管导管内分泌物量,使患者更好地耐受气管导管,便于气道管理。

Objective To monitor the obstructive sleep apnea - hypopnea syndromes after operation and observe the intervention effect of penehyclidine hydrochloride Injection. Methods Forty - five patients （ ASA I ,BMI 30.3 ± 2.6kg/m2 , AHI 28.2 ± 2.8/h, 35 ±50years old） with tracheal catheter after operation were randomly divided into three groups in ICU. Patients received atropine （group A） ,penehyclidine hydrochloride （group B）or water（group C） injection intramuscular. Signs and the amount of endotracheal tube secretions were observed at 1,6 and 10h after treatment. Results There was no difference in the MAP and HR among the three groups before treatment （ P 〉 0.05 ）. There was significant differences in the MAP and HR between B group and A and C groups. The amount of endotracheal tube secretions in group A and B was significantly less than that in group C（P 〈 0.01 ）. Conclusion Application of penehyclidine hydrochloride in OSAS with tracheal catheter can inhibit endotracheal tube secretions,make patients better tolerated tracheal catheter and airway management.