乌拉地尔预防性干预对垂体后叶素诱发心血管反应的效果观察

摘要

Objective To evaluate the effect of Urapidil preventive intervention on pituitrin-induced cardiac functions and hemodynamics of the patients underwent laparoscopic myomectomy.Methods Eighty patients underwent laparoscopic myomectomy were randomly divided into two equally-sized groups.Pituitrin 6 U + 0.9％ sodium chloride diluent 10 ml was injected around patients' hysteromyoma through a puncture needle while being monitored by a laparoscope prior to laparoscopic myomectomy.Two minutes later, Urapidil 0.3～0.5 mg/kg was injected intravenously into the patients in Group W, with a single dose below 25 mg;normal saline solution 2ml was injected intravenously into the patients in the control Group C.The following data were recorded:the BP, HR and SpO2 levels when patients entered the operation room, 1min before and 30s, 1min, 2min, 3min,5min, 10min and 30min after the pituitrin injection (the total operation duration) the amount of bleeding and troponin (cTn-I).Results The SBP and DBP levels in Group W 3min, 5min, 10min and 30min after the pituitrin injection were all significantly lower than that in Group C (P＜0.05).The HR was significantly higher in Group W 5min, 10min and 30min after the pituitrin injection than that in Group C (P＜0.05).The SBP and DBP levels decreased in both groups 30s and lmin after the pituitrin injection when compared with the levels prior to the injection (P＜0.05), but returned to the baseline levels 2min after the injection.In Group C, the SBP and DBP levels were significantly higher 3min, 5min and 10min after the pituitrin injection than the levels before the injection (P＜0.05).The HR in both groups increased significantly (P＜0.05) 30s, lmin, 2min and 3min after the injection, but the HR in group C 5min, 10min and 30min after the injection were significantly lower than that before the injection (P＜0.05).The percentages of patients with positive troponin values in Group W and C were 0％ (0/40) vs 5％ (2/40), respectively, without significant differences between the two groups (P=0.487).Conclusion Urapidil preventive intervention can reduce the effect of pituitrin on patients' cardiac functions and hemodynamics, thus helping to prevent myocardial hypoxia.%目的 探讨乌拉地尔预防性干预对垂体后叶素诱发腹腔镜子宫肌瘤剔除术患者心功能及血流动力学变化的效果观察.方法 择期行腹腔镜子宫肌瘤剔除术患者80例,随机分成2组,子宫肌瘤剔除术前将垂体后叶素6U+0.9％氯化钠稀释液10ml经穿刺针于腹腔镜监视下刺入肌瘤周围肌层注射,2min后A组静脉注射乌拉地尔0.3～0.5mg/kg,单次量不＞25mg,B组静脉注射生理盐水2ml为对照.记录入手术室时,垂体后叶素注射前1 min,注射后30s、1min、2min、3min、5min、10min、30min时的SBP、DBP、HR和SpO2,记录手术时间、出血量及术前和术后的肌钙蛋白I(cTn-I).结果 注射垂体后叶素后3min、5min、10min、30minA组SBP和DBP均低于B组(P＜0.05);注射垂体后叶素后5min、10min、30minA组HR高于B组(P＜0.05);与注射垂体后叶素前1min比较,给药后30s、1min时两组SBP、DBP均降低(P＜0.05),给药后2min SBP、DBP恢复至基础值,B组注射垂体后叶素后3min、5min、10min时SBP、DBP均高于给药前(P＜0.05),给药后30s、1min、2min、3min时两组HR均增快(P＜0.05),给药后5min、10min、30min时B组HR低于给药前(P＜0.05).A组和B组肌钙蛋白阳性率分别为0％(0/40)和5％(2/40),差异无统计学意义(P=0.487).结论 乌拉地尔预防性干预能减轻垂体后叶素对心功能和血流动力学的影响,有预防心肌缺氧的作用.