甲氧明预防膝关节手术止血带松气后并发低血压的效果

目的:观察甲氧明对松止血带后患者血压、脉搏的影响。方法:择期行膝关节手术患者40例,随机分为甲氧明组和对照组,每组20例,甲氧明组在手术缝合皮肤前肌注甲氧明3 mg,对照组肌注等体积的0.9%氯化钠注射液。监测并记录两组基础值(T0)、缝合皮肤前(T1)、放气后1 min(T2)放气后3 min(T3)放气后5 min(T4)各时点的SBP、DBP、HR。结果:松气后甲氧明组SBP、DBP下降幅度低于对照组[分别为(13±5)mmHg比(21±7)mmHg,P<0.05和(9±3)mmHg比(14±5)mm-Hg,P<0.05];松气后甲氧明组HR平稳;而对照组HR增快了(15±4)次/min,两组比较差异有统计学意义(P<0.01)。结论:甲氧明可预防膝关节手术后松止血带所致的血压下降。

reventive Efficacy of Methoxamine on Tourniquet Deflation-induced Hypotension in Patients with Knee Joint Surgery

Objective： To study the effect of methoxamine by intramuscular injection on blood pressure and pulse fluctuation in the orthopaedic patients with tourniquet deflation.Method： Totally 40 patients undertaken knee joint surgery with tourniquet were selected and randomly divided into two groups,each group with 20 patients.The patients in the methoxamine group received 3mg methoxamine by intramuscular injection before the surgical skin suture,while the patients in the control group received the same volume of normal saline.At the following time points,namely the basal level（T0）,before the surgical skin suture（T1）,and 1 min（T2）,3 min（T3） and 5 min（T4） after the tourniquet deflation,the hemodynamic parameters,such as systolic blood pressure（SBP）,diastolic blood pressure（DBP） and heart rate（HR） were measured.Result： After the tourniquet deflation,the decrease in SBP and DBP were significantly less in the methoxamine group than that in the control group[（13±5）mmHg vs（21±7）mmHg,P0.05 and（9±3）mmHg vs（14±5）mmHg,P0.05].Steady HR in the methoxamine groups was shown and HR was increased by（15±4）bpm in the control group after the toumiquet deflation with significant difference between the two groups（P0.01）.Conclusion： Intramuscularly injected methoxamine can effectively prevent hypotension induced by tourniquet deflation in patients with knee joint surgery.