肌肉注射甲氧明对下肢手术松止血带后血流动力学的影响

Effects of intramuscularly injected methoxamine on tourniquet deflation induced hemodynamic changes in patients with lower limb surgery

目的:观察肌肉注射甲氧明对松止血带后患者血压、脉搏、心排血量的影响。方法:择期行下肢手术患者60例,随机分为甲氧明组和对照组,每组30例,甲氧明组在手术缝合皮肤前肌肉注射甲氧明3mg,对照组肌肉注射相同体积的生理盐水。监测并记录基础值(T0)、缝合皮肤前(T1)、放气后1min(T2)放气后3min(T3)放气后5min(T4)各时点的SBP、DBP、HR、CO。结果:甲氧明组BP、CO波动不大,HR平稳;对照组BP降幅较大,CO下降明显,HR增快,有5例患者需要应用升压药。结论:肌肉注射甲氧明可预防下肢手术后松止血带所致的循环变化,保持血流动力学相对平稳。

AIM. To study the effect of intra- muscularly injected methoxamine on blood pres- sure, pulse and cardiac output fluctuation in- duced by turiquet deflation in orthopaedic pa- tients. METHODS： 60 patients scheduled for lower limb surgery with toumiquet were selected and randomly divided into two groups, each group with 30 patients. Patients in methoxamine group received intramuscular injection methox- amine 3 mg before the surgical skin saturation. Patients in control group received the same vol- ume of nomal saline. In the following time points baseline level （T0）, before the surgical skin suturation （T1）, and 1 min（T2）, 3 rain （T3） and 5 rain （T4） after the toumiquet defla- tion ,the hemodynamic parameters systolic blood pressure（SBP） ,diastolic blood pressure（DBP） , heart rate（HR） and cardiac output （CO） were measured. RESULTS： There was stable HR, blood pressure and cardiac output after the tou- rniquet deflation in methoxamine group. Whear- as, a decreased BP and CO and faster HR were observed in control group. There were statistical significance on BP and HR between two groups. CONCLUSION： Intramuscularly injected me- thoxamine could effectively prevent cyclic chan- ges induced by tourniquet deflation in patients with lower limb surgery, keep relatively stable haemodynamics.