摘要
#目的探讨氨茶碱和阿托品联合应用在心脏瓣膜置换术中对患者心动过缓的治疗作用。方法选取在心脏瓣膜置换术中，体外循环停止、复跳5 min后发生心动过缓（心率＜50次/min ）患者90例，按美国麻醉师协会标准分级（ ASA）Ⅱ～Ⅲ级，随机分为三组：A组30例，首次静注阿托品0.5 mg，无效则每5 min追加阿托品1 mg；B组30例，首次静注阿托品1 mg，无效则每5 min追加阿托品1 mg；C组30例，首次联合静注阿托品0.5 mg和氨茶碱0.125 g，无效则以相同剂量静注追加。观察并记录三组患者术中心律失常和术后恶心、呕吐等不良反应的发生情况，比较药物的平均作用剂量，分析三组的治疗有效率。结果三组患者ASA分级、体重、心功能等一般情况差异不显著（ P＞0.05）。 C组治疗有效率（90.00％）明显高于A组（46.67％）和B组（53.33％）（χ2＝14.10，P＜0.05）。 C组阿托品平均作用剂量为（0.86±0.17）mg，低于A组（1.83±0.12）mg和B组（1.79±0.45）mg（q＝6.91、7.62，P均＜0.05）。 C组不良反应发生情况明显低于A组和B组（χ2＝4.05，P＜0.05）。结论氨茶碱和阿托品联合应用对心脏瓣膜置换手术患者心动过缓具有很好的治疗作用，可有效地提高治愈率，降低毒副反应，提高麻醉安全性。
Objective To investigate bradycardia treatment effects of co-administration of aminophylline and atropine in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods When five minute after stopping CPB , ninety patients with cardiac valve replacement were randomly divided into three groups:Group A:30 patients were infused intravenously 0.5 mg atropine in the first place .Atropine 1 mg would be added every five minute if ineffective .Group B:30 patients were infused intravenously 1 mg atropine in the first place . Atropine 1 mg would be added every five minute if ineffective .Group C:30 patients were infused intravenously 0.5 mg atropine and 0.25 mg aminophylline in the first place .The same dosage was added every five minute if ineffective.Nausea,vomiting and arrhythmia in three groups were observed and recorded respectively .At the same time,the average drug doses were compared ,effective rate of treatment was analyzed in three groups .Results ASA grade,weight and heart function had no difference among the three groups ( P >0.05 ) .The effective rate of treatment in group C was higher than that of group A and group B ( P<0.05 ) .The average drug doses of atropine and adverse reaction in group C were lower than that of group A and group B ( P<0.05 ) .Conclusions During operation of cardiac valve replacement , co-administration of aminophylline and atropine have a good therapeutic effect for bradycardia , which can improve cure rate effectively , decrease toxic side effect and reduce adverse reaction .
出处
《心血管外科杂志（电子版）》
2013年第3期121-123,共3页
Journal of Cardiovascular Surgery(Electronic Edition)
关键词
心动过缓
氨茶碱
阿托品
心脏瓣膜
人工
Bradycardia
Aminophylline
Atropine
Heart valve prosthesis
