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    硫酸镁对腹腔镜下子宫肌瘤切除术中垂体后叶素诱发血流动力学波动的影响

    Effects of magnesium sulfate on pituitrin-induced hemodynamics fluctuation during laparoscopic myomectomy

    • 摘要: 目的 探讨应用硫酸镁对腹腔镜下子宫肌瘤剥脱术中子宫体注射垂体后叶素诱发的循环波动的影响。方法 选择择期行腹腔镜下子宫肌瘤剥脱术的患者50例,按随机数字表法分为硫酸镁组和对照组,各25例。硫酸镁组在注射垂体后叶素前10 min,缓慢静脉推注40 mg·kg-1负荷剂量硫酸镁,随后以30 mg·kg-1·h-1持续泵注30 min;对照组在注射垂体后叶素前10 min缓慢静脉推注相同容积的生理盐水,随后持续泵注相同容积生理盐水30 min。记录2组患者麻醉诱导后(T1)、注射垂体后叶素前10 min(T2)、子宫体注射垂体后叶素后5 min(T3)、10 min(T4)、20 min(T5)以及术毕冲洗缝皮时(T6)各时间点平均动脉压(MAP)和心率(HR)。记录患者术中Fromme术野质量评分、术中出血量、术中血清镁离子浓度、患者苏醒时间、拔管时间以及拔管后5 min和20 min的疼痛数字评分(NRS评分)。结果 在T3~T5时点,硫酸镁组MAP水平明显低于对照组,HR水平明显高于对照组(P<0.05)。2组患者的术中Fromme术野质量评分和术中出血量差异无统计学意义(P>0.05)。与对照组相比,硫酸镁组T3、T6时点血清Mg2+浓度水平更高,硫酸镁组在拔管后5、20 min NRS评分降低,差异有统计学意义(P<0.05)。结论 腹腔镜下子宫肌瘤剥脱术中预先注射硫酸镁可减轻子宫体注射垂体后叶素诱发的循环波动,减轻术后疼痛程度,且不延长患者的苏醒及拔管时间。

       

      Abstract: Objective To evaluate the effects of magnesium sulfate on circulation fluctuation induced by the injection of pituitrin into the uterine body during laparoscopic myomectomy. Methods A total of 50 patients who were scheduled for laparoscopic myomectomy were enrolled. According to the random number table method, they were divided into two groups (n=25): a magnesium sulfate group and a control group. Then, 10 min before pituitrin injection, the magnesium sulfate group was intravenously infused with magnesium sulfate at a loading dose of 40 mg·kg-1, followed by continuous pumping at 30 mg·kg-1·h-1 over 30 min. Meanwhile, 10 min before pituitrin injection, the control group was intravenously infused with the same volume of normal saline, followed by continuous pumping with the same volume of normal saline over 30 min. Their mean arterial pressure (MAP) and heart rate (HR) were collected after anesthesia induction (T1), 10 min before pituitrin injection (T2), 5 min after pituitrin injection (T3), 10 min after pituitrin injection (T4) and 20 min after pituitrin injection (T5), and after surgery (T6). Their Fromme scores, the volume of intraoperative blood loss, serum magnesium ion concentration, recovery time and extubation time were recorded. Their pain scores (NRS score) were evaluated 5 min and 20 min after extubation. Results Compared with the control group, the magnesium sulfate group presented remarkably reduced MAP and increased HR at T3-T5 (P<0.05). No difference was found in Fromme scores and the volume of intraoperative blood loss between the two groups (P>0.05). Compared with the control group, the magnesium sulfate group produced remarkable decreases in NRS scores 5 min and 20 min after extubation (P<0.05). Conclusions Pre-injection of magnesium sulfate can reduce the circulation fluctuation induced by the injection of pituitrin into the uterine body during laparoscopic myomectomy, and relieve the degree of postoperative pain, without prolonging patient recovery and extubation time.

       

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