上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (12): 1502-.

• 论著（临床研究） • 上一篇    下一篇

硫酸镁用于鼻内窥镜手术控制性降压的临床研究

周为民1, 陈锡明2, 侯瑞礁1, 沈伯雄1   

  1. 上海交通大学 医学院 1. 第三人民医院麻醉科, 上海 201900；2. 新华医院麻醉科, 上海 200092
  • 出版日期:2009-12-25 发布日期:2009-12-25
  • 通讯作者: 陈锡明, 电子信箱: ximingchen@yahoo.com。
  • 作者简介:周为民（1971—）, 男, 副主任医师, 硕士；电子信箱: hrjzwm@163.com。

Clinical study of controlled hypotension with magnesium sulphate during functional endoscopic sinus surgery

ZHOU Wei-min1, CHEN Xi-ming2, HOU Rui-jiao1, SHEN Bo-xiong1   

  1. 1. Department of Anesthesia, The Third People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 201900, China；2. Department of Anesthesia, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
  • Online:2009-12-25 Published:2009-12-25

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摘要：

目的 观察硫酸镁在鼻内窥镜手术中控制性降压的临床效果和安全性。方法 75例全身麻醉下鼻内窥镜择期手术患者，随机分为对照组、硫酸镁组和硝酸甘油组，每组25例。硫酸镁组在麻醉诱导前予以静脉输注10%硫酸镁40 mg/kg，继以15 mg·kg-1·h-1维持；对照组给予同等容量的5%葡萄糖液；硝酸甘油组术中泵注硝酸甘油，以1 μg·kg-1·min-1开始。观察用药后各时点的血流动力学变化、术中出血量及输液量、手术及苏醒时间、术野质量、肌松情况及不良反应。结果 硫酸镁组患者术中心率平稳，而对照组和硝酸甘油组患者术中心率较麻醉前明显加快（P<0.01）。硫酸镁组术中出血量明显少于对照组（P<0.01），手术时间短于对照组（P<0.01）。硫酸镁组术中各时点术野质量评分明显优于对照组（P<0.01）。末次给药后至肌颤搐75%恢复的时间和恢复指数在组间比较，硫酸镁组明显大于硝酸甘油组和对照组（P<0.01）。各组均未发生明显的不良反应。结论 硫酸镁可有效地的用于鼻内窥镜手术的控制性降压。

关键词: 硫酸镁, 硝酸甘油, 鼻内窥镜手术, 控制性降压

Abstract:

Objective To investigate the effect and safety of administering magnesium sulphate as a technique of controlled hypotension during functional endoscopic sinus surgery. Methods Seventy-five patients arranged for selective functional endoscopic sinus surgery under general anesthesia, were randomly assigned into three groups: control group, magnesium sulphate group and nitroglycerin group(n=25). The patients of magnesium sulphate group received 10% magnesium sulphate 40 mg/kg before the induction of anaesthesia, and then 15 mg·kg-1·h-1 by continuous infusion during the operation. The same volume of5% glucose was administered to the patients in control group. Constant infusion of nitroglycerin beginning with 1 μg·kg-1·min-1 was administered to the patients in nitroglycerin group. The hemodynamic indexes, amount of bleeding, fluid intake, operation time, recovery time, quality of surgery field, muscle relaxation and adverse reaction were recorded. Concentration of Mg2+ in magnesium sulphate group were compared before and after surgery. Results The patients in the magnesium sulphate group maintained balanced heart rates during the operation, while the heart rates of patients in control group and nitroglycerin group increased significantly （P<0.01）. The patients of magnesium sulphate group had lower amount of bleeding and shorter operation time compared with control group （P<0.01）. The quality of surgery field in magnesium sulphate group was significantly better than that in control group （P<0.01）. Time for 75% recovery of myokymia and recovery index in magnesium sulphate group was higher than those in control group and nitroglycerin group（P<0.01）. No adverse reaction was observed in all groups. Conclusion Magnesium sulphate can be effective and safe for controlled hypotension during functional endoscopic sinus surgery.

Key words: magnesium sulphate, nitroglycerin, functional endoscopic sinus surgery, controlled hypotension