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目的研究环磷酸腺苷葡胺(心先安,McAMP)围术期对心肌缺血老年病人心肌梗死的预防和治疗作用。方法40例有心肌缺血基础的老年病人随机分为治疗组和对照组,每组各20例。治疗组在麻醉诱导前10min静脉注射心先安20mg,随后160mg加入100ml0.9%氯化钠注射液中持续缓慢静脉滴注;对照组静脉滴注0.9%氯化钠注射液。术中纪录心电图各导联ST段水平、MAP和HR,并计算HR与SBP的乘积(RPP);同时抽取外周静脉血检测术前、术毕、术后24h血清心肌肌钙蛋白I(cTnI)水平。结果术中对照组出现明显的ST段下降和RPP升高,与治疗组比较差异有统计学意义(P<0.05);治疗组术后cTnI水平的升高程度较对照组为低(P<0.05)。术后对照组有2例出现灶性心肌梗死。结论心先安预防和治疗老年患者围术期心肌缺血、心肌梗死具有较好的作用。
Objective To investigate the preventive and therapeutic effects of perioperative myocardial infarction (AMC) on myocardial infarction in elderly patients with myocardial ischemia. Methods Forty elderly patients with myocardial ischemia were randomly divided into treatment group and control group, with 20 cases in each group. Patients in the treatment group received intravenous injection of 20 mg of phentolamine 10 min before induction of anesthesia, followed by continuous slow intravenous infusion of 160 mg in 100 ml of 0.9% sodium chloride injection. In the control group, 0.9% sodium chloride injection was administered intravenously. Intraoperative ECG ST lead levels, MAP and HR, and calculate the product of HR and SBP (RPP); while taking peripheral venous blood test before surgery, at the end of surgery, after surgery, serum cardiac troponin I (cTnI) Level. Results There was a significant decrease of ST segment and RPP in the control group (P <0.05), and the level of cTnI in the treatment group was lower than that of the control group (P <0.05) ). There were 2 cases of focal myocardial infarction in the control group after operation. Conclusions Xin Xian prevent and treat elderly patients with perioperative myocardial ischemia, myocardial infarction has a good effect.