去氧肾上腺素对腹腔镜子宫肌瘤剔除术患者局部注射缩宫素后血流动力学的影响

目的探讨去氧肾上腺素对腹腔镜子宫肌瘤剔除术患者局部注射缩宫素后血流动力学的影响。方法 36例ASAⅠ-Ⅱ级择期行腹腔镜下子宫肌瘤剔除术患者,随机分为3组,每组12例,Ⅰ、Ⅱ、Ⅲ组分别于局部注射缩宫素时静脉注射去氧肾上腺素1μg/kg、2μg/kg、3μg/kg,记录注射缩宫素前1min基础值（T0）、注射缩宫素即刻（T1）、注射缩宫素后30s（T2）、1min（T3）、3min（T4）、5min（T5）时收缩压（SBP）、舒张压（DBP）及心率（HR）的变化。结果Ⅰ组患者SBP、DBP在T2、T3、T4时较基础值降低（P〈0.05）,HR较基础值增高（P〈0.05）;Ⅱ组患者SBP、DBP无明显变化（P〉0.05）,HR较基础值降低（P〈0.05）;Ⅲ组患者SBP、DBP在T3、T4、T5时较基础值增高（P〈0.05）,HR较基础值降低（P〈0.05）。结论注射缩宫素时静脉给予2μg/kg去氧肾上腺素可使血流动力学保持相对稳定。

Effect of phenylephrine on hemodynamics in patients undergoing laparoscopic uterine myomatectomy after injection of oxytocin

Objective To study the effect of phenylephrine on hemodynamics in patients undergoing laparoscopic uterine myomatectomy after injection of oxytocin.Methods Thirty-six patients at ASAⅠ-Ⅱundergoing laparoscopic myomectomy were divided into three groups（12 in each group）.Patients in 3 groups were injected with phenylephrine at the dose of 1μg/kg,2μg/kg and 3μg/kg,respectively,in combination with oxytocin.Heart rate,systolic and diastolic blood pressure of the patients were recorded 1min before oxytocin injection（T0）,at the time of oxytocin injection（T1）,30s,1,3 and 5min after oxytocin injection（T2,T3,T4,T5）.Results The systolic and diastolic blood pressures of patients in group A were decreased at T2,T3 and T4（P0.05）and their heart rate was slightly increased（P0.05）.No significant change was observed in systolic and diastolic blood pressures of patients in group B（P0.05） and their heart rate was decreased（P0.05）.The systolic and diastolic blood pressures of patients in group C were significantly increased and their heart rate was decreased（P0.05）.Conclusion Injection of oxytocin in combination with phenylephrine at the dose of 2μg/kg can maintain the relatively stable hemodynamics in patients undergoing laparoscopic uterine myomatectomy.