盐酸戊乙奎醚与阿托品在妇科腹腔镜手术中的效果比较

Effects of Penehyclidine Hydrochloride and Atropine in Gynecological Laparoscopic Surgery

目的:比较分析盐酸戊乙奎醚(长托宁)与阿托品在妇科腹腔镜患者术前用药对呼吸道分泌物和血流动力学的影响。方法:选取100例行妇科腹腔镜手术的患者随机分为实验组(盐酸戊乙奎醚组或长托宁组)与对照组(阿托品组),每组各50例,两组患者在麻醉前分别静脉注射盐酸戊乙奎醚和阿托品,分别记录两组患者给药前(T1)、给药后10min(T2)、给药后20min(T3),给药后30min(T4)患者心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2)。采用视觉模拟评分法(VAS)评定口干程度;观察手术结束及气管导管拔除前后口腔及呼吸道分泌物情况并计量(m L)。结果:长托宁组给药后HR在各时点的变化差异无统计学意义(P>0.05),阿托品组给药后各时点HR较给药前有显著升高(P<0.01),尤其是给药后10min显著升高(P<0.01)。两组患者VAS评分给药后30min及拔管后较给药前均升高(P<0.01),阿托品组气管及口鼻腔分泌物的量明显多于长托宁组。结论:盐酸戊乙奎醚作为妇科腹腔镜患者术前用药,抑制腺体分泌效果较好,血流动力学平稳,较阿托品更安全有效。

Objective： To investigate the effects of puvecionine hydrochloride and atropine on respiratory secretions and hemodynamics in patients with gynecological laparoscopic surgery. Methods： A total of 100 patients underwent gynecological laparoscopic surgery were randomly divided into two groups ： penehyclidine hydrochloride group and atropine group. Two groups of patients were intravenous injection of penehyclidine hydrochloride and atropine before anesthesia. HR, MAP, and SpO2 were measured before treatment （T1） , 10 min after administration （T2）, 20 min after administration （T3）, 30 rain after administration （T4）. The degree of dryness was assessed by visual analogue scale （VAS） , and the condition of oral and respiratory secretions before and after the removal of tracheal tube was observed and measured （mL）. Results： There was no significant difference in the change of HR at each time point after the administration of the tropine group （ P 〉 0. 05 ）. HR at each time after administration of atropine group was significantly higher than that before administration （ P 〈 0. 01 ） , especially at 10 min after administration. The VAS scores of the two groups were increased after 30 rain and after extubation （ P 〈 0. 01 ） ,and the amount of endotracheal and nasal secretions in the atropine group was significantly higher than that in the long tonic group. Conclusion： Penehyelidine hydroehloride is a safe and effective method for the treatment of gynecologic laparoscopic patients, and it is more safe and effective than atropine.