实用医学杂志2011年第27卷第11期
药物与临床
老年患者开胸术前
硝酸甘油雾化吸入对氧分压的影响
顾正峰高宏王军黄东晓胡毅平
摘要目的:观察老年患者开胸手术前
硝酸甘油雾化吸入后对氧分压的影响。方法:选择年龄65岁以
上拟行开胸手术的老年患者40例,随机分为两组。入院后患者吸氧、抗炎及肺功能炼。生理盐水(NS)组
以生理盐水雾化吸入,硝酸甘油(Niro)组以硝酸甘油雾化吸入,吸入前监测BP、HR、ECG和SpO2。分别于入
院时、吸入治疗后行血气分析,观察氧分压的变化。结果:两组患者的氧分压均得到不同程度的提高, Nitro
组与NS组比较差异有统计学意义(P<0.05)。结论:硝酸甘油雾化吸入可以更好的改善老年患者麻醉前的
氧分压。
关键词氧分压;硝酸甘油;雾化吸入;老年人
Efficacy of nebulized nitrogly erin inhalation in the preoperative preparation with thoracotomy of elder
patients GU Zheng- feng, GAO Hong, WA NG n, HUA NG Dong-xiao, HU Yi-ping. *Department of
A nesthesiology, Wuxi Peoples Hospital, Alated Nanjing Medical niversity, Wumi 214023, China
Abstract) Objective To observe the influence of the partial pressure of oxygen in the elder patients
with nebulized nitroglycerin inhalation before thoracic sur ery. Methods 40 patients over 65 years old before
thoracic surgery were randomly divided into two groups. The patients were treated by routine oxygen inhalation
anti-inflammation and functional exercise of lung after admission. Furthermore, the control group inhale
nebulized normal saline and the observed group inhaled nebulized nitroglycerin. The BP, HR, ECG and Spo
rere monitored during the inhalation. The aerial blood gus analysis was performed and the change of partial
pressure of oxygen was observed. Results The partial pressure of oxygen in the two groups were both increased
There was significant difference between the two groups(P< 0.05). Conclusion Nebulized nitroglycerin
inhalation may be better improve the partial pressure of oxygen in the elder patients before anesthesia
Key words] Partial pressure of oxygen; Nitroglycerin; Nebulized inhalation; Elder patients
近年来老年患者的比例不断增加,且许多老片以及做心脏彩超等检査将原有严重的心、肺
年患者伴有其他合并症,使麻醉手术前的准备工肝、肾和神经系统疾患者排除在外。行桡动脉血气
作显得尤为重要。许多老年患者入院后血气分析分析,氧分乐低于70 mmhg的列入研究对象,共
显示低氧血症,明显增加了麻醉和手术的风险。对40例,随机均分为生理盐水组( normal saline,Ns
此必须进行积极的手术前准备,包括氧疗、抗炎、组)和硝酸甘油组( nitroglycerin, Nitro组)。男21
肺功能锻炼及合并症的治疗等。为此,我们以硝酸例,女19例,年龄均大于65(71±5.6)周岁,体重
甘油雾化吸人用于老年患者开胸手术前准备,以(56.3±7.1)kg,身高(158±5.7)em。其中食管癌
期更好的纠正低氧血症,取得了较好的治疗效果,19例,责门癌21例
报告如下。
1.2方法在术前准备期除抗炎、吸氧和肺功能
1资料与方法
锻炼外,NS组以10mL生理盐水,Niro组以硝酸
1.1一般资料选择ASAI或Ⅱ级,择期行食管甘油20pg/kg"リ加生理盐水到10mL,用一次性雾
癌或贲门癌根治术患者,人院后通过摄胸部X线化吸人器以氧气为驱动行雾化吸人,氧流量为10
/min。每天早晚各一次,共2d,吸入时以 Datex
心电监护仪测BP、HR、SpO2和ECG,观察并记录
doi:10.3969/jis.1006-5725.201.1.050
吸入前后有无变化。第二天吸入结束后1h经桡
基金项目:南京医科大学面土项目(编号:08 NMUMO94)
作者单位:214023江苏省无锅市,南京医科大学附属无锡方动脉抽血作血气分析,与人院时动脉血气分析作
人民医院酥醉科(顾正峰,髙宏,王军,黄东晓);214002江苏省
比较。
无锡市第二人民医院麻醉科(胡毅平)
统计学分析计量资料以均数士标准差表
通信作者:胡毅平E-mail:yipinghu554@yahoo.com.cn
示,计量资料采用成组设计的t检验(方差不齐时