参附注射液对急诊气管插管患者血压的影响

Effect of Shenfu Injection on Blood Pressure of Emergency Intubated Patients

目的观察急诊气管插管麻醉诱导前应用参附注射液对患者血压的影响。方法将67例急诊气管插管患者随机分为观察组(36例)和对照组(31例)。观察组麻醉诱导前予参附注射液50 mL,静脉注射;对照组予生理盐水100 mL,静脉滴注。比较2组患者插管前后血压、心率及血管活性药物使用率、机械通气时间、28 d死亡率。结果 2组患者诱导前(T1)、插管前(T2)血压及心率与输液前(T0)比较,差异无统计学意义(P>0.05);插管完成即刻(T3)血压较T2上升(P<0.05);插管完成5 min(T5 min)血压及心率均下降,T5 min与T3、T0比较,差异有统计学意义(P<0.01,P<0.05)。观察组于插管10 min(T10 min)起血压及心率恢复至T0水平(P>0.05)。对照组T10 min起心率恢复至T0水平(P>0.05);插管30 min(T30 min)血压仍较T0下降(P<0.05),2组比较差异有统计学意义(P<0.01)。使用血管活性药物后,对照组插管60 min(T60 min)血压恢复到T0水平(P>0.05)。血管活性药物使用率及机械通气时间比较,观察组均少于对照组(P<0.05)。2组患者死亡率差异无统计学意义(P>0.05)。结论急诊气管插管麻醉诱导前静脉注射参附注射液能改善插管后低血压,减少血管活性药物使用率和使用时间,减少机械通气时间。

Objective To observe the effect of Shenfu Injection on blood pressure intravenously given before induction of anesthesia in emergency intubation. Methods Sixty-seven cases of emergency intubation were randomly divided into observation group （36 cases） and control group （31 cases）. Before induction of anesthesia, the observation group was intravenously given 50 mL of Shenfu Injection, while intravenous infusion of saline 100 mL was given to control group. The blood pressure and heart rate before and after intubation, the vasoactive drugs usage, the duration of mechanical ventilation, and the 28 days’ mortality of the two group were compared. Results There was no significant difference in blood pressure and heart rate before induction （T1）, before intubation （T2） compared with before infusion （T0） （P〉0.05）. The blood pressure of the two groups rose immediately with intubation finished （T3） （P〈0.05）. Five minutes after intubation finished （T5 min）, there was significant difference in blood pressure and heart rate compared with T3 and T0 （P〈0.01, P〈0.05）. For observation group, the blood pressure and heart rate recovered to the level before the infusion from T10 min （P〉0.05）. For control group, heart rate recovered to the level before the infusion from T10 min （P〉0.05）, but the blood pressure T30 min was still decreased compared with T0 （P〈0.05）. The difference between the two groups was significant （P〈0.01）. After using vasoactive drugs, blood pressure T60 min of control group returned to T0 level （P〉0.05）. The observation group used less vasoactive drugs and had shorter mechanical ventilation time （P〈0.05）. There was no significant difference in mortality between the two groups （P〉0.05）. Conclusion For emergency intubation, intravenous Shenfu Injection before induction of anesthesia can improve hypotension after intubation, reduce the dosage and time of vasoactive drugs, reduce duration of mechanical ventilation.