佩尔地平对垂体后叶素在子宫肌瘤剔除术中心血管反应的影响

Efficacy of perdipine in preventing pituitrin-induced cardiovascular responses in patients undergoing myomectomy

目的探讨不同时间点预注佩尔地平对垂体后叶素诱发子宫肌瘤剔除术中心血管反应的影响。方法选择择期腹腔镜子宫肌瘤剔除术患者105例,ASAⅠ或Ⅱ级,随机分为3组。肌瘤剔除术前,腹腔镜直视下在肌瘤周围肌层注入垂体后叶素6 U,在注射垂体后叶素1 min,1.5 min,2 min后,即A组、B组、C组,分别静脉注射佩尔地平3μg/kg。记录注射垂体后叶素时(T0),及用药后30 s(T1)、1 min(T2)、1.5 min(T3)、2 min(T4)、5 min(T5)、10 min(T6)、30 min(T7)时患者的MAP和HR。结果两组一般资料、手术时间、出血量均无统计学意义;与T0比较,T1、T2时刻三组MAP明显降低(P<0.05);T3、T4时刻,A组MAP明显降低,而T5~T7时刻MAP明显升高(P<0.05);T4时刻,B组MAP明显降低,而T6、T7时刻MAP明显升高(P<0.05);T4、T6、T7时刻,C组MAP明显增加,而T5时刻明显降低(P<0.05)。与T0相比,T1~T7时刻三组HR均明显增加(P<0.05);T3~T7时刻,A组心率增加明显高于B组和C组(P<0.05);在T5时刻,C组心率增加高于B组(P<0.05)。结论局部注射垂体后叶素1.5 min后预注佩尔地平3μg/kg能明显改善其引起的心血管反应。

Objective To study the effect of perdipine on pituitrin-induced cardiovascular responses at different time points in patients undegoing myomectomy. Methods One-hundred and twenty patients（ ASAⅠorⅡ） undergoing laparoscopic myomectomy under general anesthesia were equally and randomly divided into 3 groups. Pitutrin 6 U were diluted in 20 ml normal saline,and injected around hysteromyoma. After pitutrin injected for 1 min（ group A）,1.5 min（ group B）,2 min（ group C）,3 ug/kg perdipine was injected intravenously. The mean artery blood pressure（ MAP） and heart rate（ HR） were recorded at the time（ T0） and 30 seconds（ T1）,1 minute（ T2）,1.5 minutes（ T3）,2 minutes（ T4）,5 minutes（ T5）,10 minutes（ T6）,30 minutes（ T7） after injection of pituitrin. Results The operation time,age,weight and the amount of bleeding in two groups had no significant statistical differences. Compared with T0,the MAP in three groups obviously decreased at T1,T2（ P〈0.05）;MAP in group A obviously decreased at T3 and T4,while that significantly increased at T5 - T7（ P〈0.05）; In group B,MAP increased at T4 and decreased at T6,T7（ P〈0.05）; In group C,MAP increased at T4,T6,T7 and decreased at T5（ P〈0.05）. Compared with T0,HR significantly increased in three groups at T1 - T7. At T3 - T7,HR increased more significant in group A than that in group B and C（ P〈0.05）; HR in group C increased more obviously than that in group B at T5. Conclusions After pituitrin injected for 1. 5 min,3 ug/kg perdipine can effectively prevent pituitrin-induced cardiovascular responses.