摘要
目的对比评价盐酸戊乙奎醚与东莨菪碱作为冠心病患者术前用药的安全性。方法ASAⅡ～Ⅲ级全麻下行非体外循环冠状动脉搭桥术的冠心病患者40例。随机分为两组。每组20例，P组：术前静注盐酸戊乙奎醚0．01mg／kg，S组：术前静注东莨菪碱0．01mg／kg。分别记录给药前（TO），给药后5min（T1）、10min（T2）、30min（T3）的口干VAS评分；TO、T1、T2、T3、60min（T4）、90min（T5）的唾液分泌量和HR、SBP、DBP、SpO2、RPP。结果口干程度的VAs评分两组在各时点差异无统计学意义（P〉0．05）。两组在T1、T2、T3的唾液分泌量与T0比明显减少，与S组相比，P组在T4、T5的唾液分泌量仍显著减少（P〈0．05）。P组给药后各时点与给药前比较，HR无显著变化（P〉0．05）．与P组比较，S组在给药后的HR、RPP显著增加（P〈0．05）。结论盐酸戊乙奎醚作为冠心病患者术前用药优于东莨菪碱，对心率影响小，效果确切、安全。
Objective To compare and evaluate the efficacy and safety of penehyclidine hydrochloride and scopolamine used as premeditation in patients with coronay heart disease. Methods Forty patients （ASA Ⅱ - Ⅲ） with coronay heart disease undergoing off-pump coronary artery bypass graft were randomly divided into penehyclidine group （P group） and scopolamine group （S group）. Penehyclidine hydrochloride 0. 01 mg/kg （P group） and scopolamine 0.01 mg/kg （S group） were administered intravenously respectively before operation. The degree of hydrodipsia （VAS grading） was recorded at TO （before administration）, T1 （5 min after administration）, T2 （10 min after administration）, and T3 （30 min after administration）. The saliva secretory volume, HR, SBP, DBP, SpO2 and RPP were recorded at TO, T1, T2, T3, T4 （60 min after administration）, and T5 （90 min after administration）. Results There were statistical differences in the degree of hydrodipsia （VAS grading） between two groups at various time-points （P〉0.05）. The saliva secretory volume was significantly decreased after injection in two group （P〈0.05）. As compared with that of S group, the saliva secretory volume was much lower in P group at T4 and T5 （P〈0. 05）. There wasn＇t significant change of HR in P group before and after administration. HR and RPP were markedly elevated in S group after administration, much higher those of P group （P〈0.05）. Conclusion The therapeutic effect of penehyclidine hydrochloride is superior to that of scopolamine as premeditation in patients with coronary heart disease. Compared with scopolamine, penehyclidine hydrochloride is more effective and safer, and has less influence on HR.
关键词
盐酸戊乙奎醚
冠心病
术前用药
心率
唾液
penehyclidine hydrochloride
coronary heart disease
premeditation
heart rate
saliva
