去氧肾上腺素可减轻缩宫素在子宫肌瘤剔除术中对循环系统的影响

目的观察在子宫肌瘤剔除术中缩宫素对循环系统的影响,探讨预防性应用去氧肾上腺素的可行性。方法选择在腰硬联合麻醉下行子宫肌瘤剔除术的患者60例,ASAⅠ或Ⅱ级,随机分为A组(单纯缩宫素组n=30)与B组(预防性应用去氧肾上腺素组n=30)。手术过程中A组子宫局部注射缩宫素20U,B组在给予缩宫素的同时静脉缓慢注射去氧肾上腺素2μg/kg,在注射缩宫素前(T0)、注射后1min(T1)、注射后3min(T2)和注射后5min(T3)时用监护仪同时监测并记录A、B两组的收缩压(SBP)、舒张压(DBP)、心率(HR)。结果 A组患者中,与T0相比,T1、T2的SBP和DBP降低,HR升高,差异有统计学意义(P<0.05),与T1相比,T2的SBP和DBP降低,HR升高,差异有统计学意义(P<0.05),T3的SBP、DBP、HR无明显变化,差异无统计学意义(P>0.05);B组患者中,与T0相比,T1、T2、T3的SBP、DBP、HR无明显变化,差异无统计学意义(P>0.05);A组与B组相比,T1、T2的SBP和DBP降低,HR升高,差异有统计学意义(P<0.05),T3的SBP、DBP、HR无明显变化,差异无统计学意义(P>0.05)。结论在子宫肌瘤剔除术中应用缩宫素可致血压下降,心率增快,去氧肾上腺素可减轻缩宫素在子宫肌瘤剔除术中对循环系统的影响。

Phenylephrine reduced the effects of oxytocin on the circulatory system in myomectomy

Objective To observe the effects of oxytocin and prophylactic use of phenylephrine on the circulatory system in myomectomy. Methods Sixty patients performed the myomectomy were selected with epidural anesthesia,ASA Ⅰ and Ⅱ,randomly divided into group A and B (n=30).In group A,oxytocin 20 units was injectied into the local uterus during the operation.In group B,phenylephrine 2 μg/kg was injectied slowlly into intravenous while injecting oxytocinon.In two groups,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR) were monitored and recorded.Results In group A,T1,T2 compared with T0,SBP and DBP were decreased,HR were increased significantly the difference was statistically significant(P<0.05),T2 compared with T1,SBP and DBP were decreased,HR were increased,the difference was statistically significant(P<0.05),the changes of SBP,DBP,HR in T3,were not obvious,the difference was not statistically significant(P>0.05), In group B,T1,T2,T3 compared with T0,the SBP,DBP,HR had no significant changes,the difference was not statistically significant(P>0.05). Group B compared with group A,SBP and DBP were decreased and HR increased significantly in T1 and T2,the difference was not statistically significant(P<0.05),the SBP,DBP,HR had no significant changes in T3,the difference was not statistically significant(P>0.05).Conclusion The application of oxytocin decreased blood pressure,increase heart rate in myomectomy,phenylephrine reduced the effect of oxytocin on the circulatory system in myomectomy.