参附注射液对老年膝关节置换术围术期循环稳定性的影响

目的：观察参附注射液对老年患者膝关节置换术围术期循环稳定性的影响。方法：选择60例行膝关节置换术老年患者随机分为参附组和对照组各30例。参附组在麻醉前将1 mL/kg的参附注射液溶于200 mL的生理盐水中，术前20分钟内输完，对照组则使用同等量的生理盐水代替。2组均采用腰麻-硬膜外联合麻醉。观察麻醉前（T1）、麻醉后（T2）、胫骨扩髓后（T3）、放骨水泥后（T4）、术毕松止血带后（T5）5个时间点的收缩压（SBP）、舒张压（DBP）、HR、SpO2、中心静脉压（CVP）。结果：参附组T2、T3及T5时间点时CVP升高（P＜0.05）， T3、T4及T5时间点时SBP、DBP降低、HR升高（P＜0.01）。T2时间点2组CVP比较差异有统计学意义（P＜0.05）；T3、T4及T5时间点2组SBP、DBP及HR比较差异均有统计学意义（P＜0.05）。结论：参附注射液用于老年人膝关节置换术可明显增强心肌泵功能，保持血流动力学平稳。

Effects of ShenFu Injection on Hemodynamics of Senile Patients with Knee Replacement in Perloperative Period

Objective： To explore the effects of ShenFu injection on hemodynamics of senile patients with knee replacement in perioperative period. Methods：Sixty patients were randomly allocated to ShenFu group and the control group. Before anaesthesia, ShenFu group accepted intravenous injection of ShenFu injection, 1mL/kg, which was dissolved in physiological saline, 200mL, finished in 20 minutes before the surgery, and the control group with the same amount of physiological saline. Both groups received combined spinal and epidural anesthesia. SBP, DBP, HR, SpO2 and CVP were observed at five time points including before （T1） and after anesthesia （T2）, after tibia ream-ing （T3）, after placing bone cement（T4） and after releasing tourniquet when the operation was over（T5）. Results：CVP was increased at T2, T3 and T5 of ShenFu group （P〈0.05）, SBP and DBP were decreased but HR was raised at T3, T4 and T5 （P〈0.01）. The difference showed statistical meaning at T2 between both groups （P〈0.05）;the difference demonstrated statistical meaning in SBP, DBP and HR at T3, T4 and T5 between both groups （P〈0.05）. Conclusion：ShenFu injection applied to senile patients with knee replacement could significantly increase myocardial pumping function and keep hemodynamics stable.