戊乙奎醚在肺叶切除术患者的应用

Clinical application of penehyclidine in patients undergoing pulmonary lobectomy

目的探讨戊乙奎醚在肺叶切除术患者的应用价值。方法 30例ASAⅠ-Ⅱ级男性肺叶切除患者分为A组(年龄65-75岁)和B组(年龄45-55岁),每组15例。A组术前20min、单肺通气时分别给予戊乙奎醚0.01、0.02mg/kg,B组术前20min、单肺通气时均给予阿托品0.01mg/kg。检测两组双肺通气(T1)时、单肺通气0、5、20min(T2、T3、T4)时的MAP、HR、潮气量(VT)、气道峰压(Ppeak)、PETCO2。结果与T1时及B组相比,A组T3、T4时VT明显增加(P<0.05);与T1时及A组相比,B组T3、T4时Ppeak明显增加(P<0.01);两组MAP、HR、PETCO2差异均无统计学意义。结论戊乙奎醚可以明显扩张肺叶切除术老年患者支气管,增加肺顺应性。

Objective To investigate the application outcomes of penehyclidine in the patients undergoing pulmonary lobectomy. Methods Thirty ASA I-II male patients undergoing pulmonary lobectomy were divided into groups of A（65-75 years old） and B（45-55 years old） with 15 cases each. The patients in group A received penehyclidine 0.01 mg/kg and 0. 02 mg/kg at 20 minutes before surgery and beginning of one-lung ventilation, respectively, and those in group B were given atropine 0. 01 mg/kg instead of penehyclidine as in group A. HR, MAP, tidal volume （ VT ）, peak airway pressure（Ppeak） and PET CO2 at T1 （ two-lung ventilation）, T2 （one-lung ventilation）, T3 （5 min after one-lung ventilation） and T4（20 min after one-lung ventilation） were compared between two groups. Results Compared with T1 and group B, VT was increased at T3 and T4 in group A （P〈0. 05）. Compared with T1 and group A, Pp^k was increased at T3 and T4 in group B（P〈0. 01）. There was no significant difference in hemodynamic index and PET CO2 between two groups. Conclusion Penehyclidine can dilate the bronchi and increase lung compliance in aged patients undergoing pulmonary lobectomy.