老年股骨骨折患者术前雾化吸入硝酸甘油对氧分压的影响.pdf

实用医学杂志2012年第28卷第24期
临床研究
老年股骨骨折患者术前雾化吸入硝酸甘油对
氧分压的影响
顾正峰辛莲高宏路通王志萍
摘要目的;观察老年股骨患者手术前雾化吸入硝酸甘油后对氧分压的影响。方法:择年龄65岁以上
股骨骨折拟行手术治疗的老年患者40例,随机均分为两组。入院后患者吸氧、抗炎、肺功能鞭炼、骨折制动
及消肿等治疗。对照组以生理盐水雾化吸入,观察组以硝酸甘油雾化吸入,吸入时监测BP、HR、EC和
SpO2。分别于入院时、吸入治疗后行血气分析,观察氧分压的変化。结果:两组患者的氧分压均得到不同程度
的提高,硝酸甘油组与生理盐水组比較差异有统计学意义(P<0.05)。结论:硝酸甘油雾化吸入可以更好地
改善老年骨折患者手术前的氧分压。
关键词硝酸甘油;雾化吸入;老年患者
The effect of nebulized nitroglycerin inhalation to the partial pressure of oxygen in the elder patients with
femoral fracture before operation GU Zheng-fe
XIN Li
GAO Hong, LU Tong, WANG Zhi-ping.
Department of Anesthesiology Wuxi People Hospital, Afiliaed Naning Medicd University, Wui 214023
CorrespondingauthorWANGZhi-pingE-mail:Wangp@wuiph.com
Abstract Objective To observe the effect of nebulized nitroglycerin inhalation to the partial pressure of
oxygen in the elder patients with femoral fracture before operation. Methods 40 patients more than 65 years
old planned to receive femoral fracture intern fixation were selected and randomly divided into two groups. The
patients were treated by routine xy en inhalation, anti-inflammation, functional exereise of lung, fracture brake
and detumescence after admission. The controll group were inhaled nebulized normal saline, while the observed
group were inhaled nebulized nitroglycerin. The BP, HR, ECG and Spo2 were monitored during the inhalation
The arterial blood gas was analyzed and the change of partial pressure of oxygen was compared between
admission and after inhalation. Results The partial pressure of oxygen in the two groups were both increased
after inhalation, which was signifieantly higher level in the nitroglycerin group than that in the normal saline
group (P<0.05). Conclusion Nebulized nitroglyeerin inhalation may better improve the partial pressure of
oxygen in the elder patients with femoral fracture before operation
Key words Nitroglyeerin; Nebulized inhalation; Elder patients
老年患者股骨骨折的发生率很高,许多患者前准备以期更好地纠正低氧血症,取得了较好的
需手术治疗。但不少老年患者伴有其他合并症,増治疗效果,报道如下。
加了麻醉手术前准备工作的复杂性。其中部分老1资料与方法
年患者入院后血气分析显示低氧血症,增加了麻1.1一般资料选择ASAI或Ⅱ级,择期拟行股
醉和手术的风险,也影响术后顺利康复。对此必须骨颈或髋臼手术的患者40例,男14例、女26例,
进行积极的手术前准备。包括氧疗、抗炎、肺功能年龄均>65周岁,除股骨受伤外无其他部位有复
锻炼、制动、消肿及合并症的治疗等。为此,我们试合伤。其中拟行股骨颈骨折内固定的患者31例
以硝酸甘油雾化吸人用于老年股骨骨折患者手术髖关节置换术的9例,一般情况见表1。人院后行
桡动脉血气分析,氧分压<70mmHg的列入研究
对象,采用数字表法随机均分为生理盐水组
doi:10.3969/ J.Issn.1006-5725.2012.24.015
( normal saline,NS组)和硝酸甘油组( nitroglycerin,
基金项目:南京医科大学面上项目(编号:08 NMUMO9
作者单位:214023江苏省无锡市,南京医科大学附属无锡市
Niro组)。通过摄胸部X线片以及做心脏彩超等检
人民医院麻醉科(颅正峰,辛莲,高宏,王志萍),骨科(路通)
査将原有严重的心、肺、肝、肾和神经系统疾患者
通信作者:王志萍E-mail:Wangzu@wuxiph.com
排除在外。