阿托品不同给药时间对改良电抽搐治疗患者口腔分泌物的影响观察(1)
摘要：目的 探讨阿托品疗前不同给药时间对于改良电抽搐患者口腔分泌物、血压、心率、血氧饱和度的影响。方法 选取江苏省扬州五台山医院MECT室2017年1月～6月首次治疗患者153例，按治疗先后顺序编号1、2、3，分为提前注射A组(编号1，A组)、提前注射B组(编号2，C组)、非提前注射组(编号3，C组)，提前注射A组患者在常规麻醉给药前2～5 min注射阿托品0.5 mg，提前注射B组患者提前6～10 min注射阿托品0.5 mg，非提前注射组患者阿托品与麻醉剂之间不间断给药。结果 三组口腔分泌物比较：提前注射A组、B组口腔中有分泌物流出者均为8例，无统计学差异(P>0.05)；非提前注射组口腔中有分泌物流出者20例，明显多于提前注射A组与B组(P<0.05)，有统计学意义；三组患者SBP/DBP、HR比较，差异无统计学意义，P>0.05；SPO2比较，非提前注射组与提前注射A组比较差异有统计学意义(P<0.05)；非提前注射组与提前注射B组比较差异有统计学意义(P<0.05)；提前注射A组与提前注射B组比较差异有统计学意义(P<0.01)。结论 MECT疗前阿托品提前2 min以上给药可以有效地减少口腔分泌物，一定程度的改善患者的气道阻力，提升血氧饱和度，建议临床尝试应用。
, http://www.100md.com
关键词：MECT；阿托品；给药时间；监测
中图分类号：R749 文献标识码：A 文章编号：1006-1959(2017)25-0038-03
Abstract：Objective To investigate the effect of different administration time before atropine treatment on oral secretions，blood pressure，heart rate and blood oxygen saturation in patients with modified electric convulsive syndrome.Methods A total of 153 patients were treated in the MECT room of Wutaishan hospital in Yangzhou，Jiangsu Province from January to June 2017.According to the treatment sequence number 1，2，3，divided into early A injection group(No.1，A group)，early injection of B group(No.2，C group)and non early injection group(No.3，C group)，early injection of A patients in general anesthesia administered before 2～5 min injection of atropine 0.5 mg in advance injection of B group were given atropine 0.5 mg ahead of 6～10 min，Non interrupted administration between early injection group with atropine and anesthetic.Results Three oral secretions：early injection of A group，B group in the oral cavity secretion outflow were 8 cases，no significant difference(P>0.05)；non early oral secretions outflow injection group 20 cases，significantly more than the early injection A group and B group(P<0.05)，the difference was statistically significant；three patients in group SBP/DBP，HR comparison，the difference was not statistically significant，P>0.05；Compared with SPO2，there was significant difference(P<0.05)between non- injection group and A group.There was significant difference between non-early-injection group and early-injected B group(P<0.05).The difference between A group and B group was statistically significant(P<0.01).Conclusion MECT treatment before treatment with atropine more than 2 min can effectively reduce the oral secretions，to some extent，improve the patient's airway resistance and improve oxygen saturation，it is recommended clinical trial application.
, 百拇医药
Key words：MECT；Atropine；Dosing time；Monitoring
改良電抽搐治疗(Modified Electraconvulsive therapy，MECT)又称改良电休克治疗，是目前精神科临床常用的一种物理治疗方法[1]。是在传统电休克基础上经过技术改良，利用现代麻醉技术，使患者在镇静和肌肉完全松弛状态下应用多参数监测技术进行电休克治疗[2]。治疗主要用于精神分裂症、情感性精神病及各类重性精神病患者的治疗，特别适用于有严重自杀意念或行为、兴奋躁动、冲动、伤人、毁物、拒食的精神病患者。阿托品可以有效减少口腔及呼吸道腺体分泌物[3]，保持呼吸道通畅，拮抗药物引起的心动过缓[4-5]，被常规应用于MECT治疗前。但对于阿托品给药是否与麻醉剂之间需要时间间隔，查询国内相关文献均无明确报道。我院MECT室于2017年1月～6月，对阿托品疗前静脉给药时间作了一定程度的临床探讨，现将具体实施方法报道如下。, http://www.100md.com(柏昊 陈爱民)
, http://www.100md.com
关键词：MECT；阿托品；给药时间；监测
中图分类号：R749 文献标识码：A 文章编号：1006-1959(2017)25-0038-03
Abstract：Objective To investigate the effect of different administration time before atropine treatment on oral secretions，blood pressure，heart rate and blood oxygen saturation in patients with modified electric convulsive syndrome.Methods A total of 153 patients were treated in the MECT room of Wutaishan hospital in Yangzhou，Jiangsu Province from January to June 2017.According to the treatment sequence number 1，2，3，divided into early A injection group(No.1，A group)，early injection of B group(No.2，C group)and non early injection group(No.3，C group)，early injection of A patients in general anesthesia administered before 2～5 min injection of atropine 0.5 mg in advance injection of B group were given atropine 0.5 mg ahead of 6～10 min，Non interrupted administration between early injection group with atropine and anesthetic.Results Three oral secretions：early injection of A group，B group in the oral cavity secretion outflow were 8 cases，no significant difference(P>0.05)；non early oral secretions outflow injection group 20 cases，significantly more than the early injection A group and B group(P<0.05)，the difference was statistically significant；three patients in group SBP/DBP，HR comparison，the difference was not statistically significant，P>0.05；Compared with SPO2，there was significant difference(P<0.05)between non- injection group and A group.There was significant difference between non-early-injection group and early-injected B group(P<0.05).The difference between A group and B group was statistically significant(P<0.01).Conclusion MECT treatment before treatment with atropine more than 2 min can effectively reduce the oral secretions，to some extent，improve the patient's airway resistance and improve oxygen saturation，it is recommended clinical trial application.
, 百拇医药
Key words：MECT；Atropine；Dosing time；Monitoring
改良電抽搐治疗(Modified Electraconvulsive therapy，MECT)又称改良电休克治疗，是目前精神科临床常用的一种物理治疗方法[1]。是在传统电休克基础上经过技术改良，利用现代麻醉技术，使患者在镇静和肌肉完全松弛状态下应用多参数监测技术进行电休克治疗[2]。治疗主要用于精神分裂症、情感性精神病及各类重性精神病患者的治疗，特别适用于有严重自杀意念或行为、兴奋躁动、冲动、伤人、毁物、拒食的精神病患者。阿托品可以有效减少口腔及呼吸道腺体分泌物[3]，保持呼吸道通畅，拮抗药物引起的心动过缓[4-5]，被常规应用于MECT治疗前。但对于阿托品给药是否与麻醉剂之间需要时间间隔，查询国内相关文献均无明确报道。我院MECT室于2017年1月～6月，对阿托品疗前静脉给药时间作了一定程度的临床探讨，现将具体实施方法报道如下。, http://www.100md.com(柏昊 陈爱民)
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