CAJ | 학술논문

目的：临床观察硬膜外麻醉下剖宫产麻醉前液体扩容的临床效果.方法：选择硬膜外麻醉下择期单胎剖宫产的足月产妇共90例,随机分为3组(n＝30),A组为麻醉前静脉输注6％羟乙基淀粉130/0．4氯化钠注射液组；B组为麻醉前静脉输注乳酸钠林格液组,C组为不用麻醉前预扩容组,每组各30例.3组均无术前用药.观察3组产妇麻醉后收缩压(SBP)、舒张压(DBP)、心率(HR)的变化,及新生儿 Apgar评分,发生恶心呕吐及麻黄素的使用等情况.结果：A、B两组麻醉后低血压的发生率、麻黄素的使用均低于C组,差异有统计学意义(P＜0．05),且 A组血流动力学较 B 组更稳定.新生儿 Apgar 评分3组间差异无统计学意义(P＞0．05).结论：在硬膜外麻醉下剖宫产麻醉前使用液体扩容能降低术中低血压的发生率,减少麻黄素的使用,对新生儿无不良影响,且胶体液的这种效果优于晶体液.
목적：림상관찰경막외마취하부궁산마취전액체확용적림상효과.방법：선택경막외마취하택기단태부궁산적족월산부공90례,수궤분위3조(n＝30),A조위마취전정맥수주6％간을기정분130/0．4록화납주사액조；B조위마취전정맥수주유산납림격액조,C조위불용마취전예확용조,매조각30례.3조균무술전용약.관찰3조산부마취후수축압(SBP)、서장압(DBP)、심솔(HR)적변화,급신생인 Apgar평분,발생악심구토급마황소적사용등정황.결과：A、B량조마취후저혈압적발생솔、마황소적사용균저우C조,차이유통계학의의(P＜0．05),차 A조혈류동역학교 B 조경은정.신생인 Apgar 평분3조간차이무통계학의의(P＞0．05).결론：재경막외마취하부궁산마취전사용액체확용능강저술중저혈압적발생솔,감소마황소적사용,대신생인무불량영향,차효체액적저충효과우우정체액.
Objective:To observe,under epidural anesthesia,the clinical effect of liquid volume expan-sion before the treatment of anaesthesia during cesarean section.Methods:60 pregnancies of the normal full-term birth from singleton caesarean section under epidural anesthesia were randomly divided into three groups,which were named A,B and C group respectively (n=30 cases/per group).Group A were those for intravenous infusion of 6% hydroxyethyl starch and 130/0.4 sodium chloride injection before anesthesia,B were those for intravenous infusion of Sodium Lactate Ringer's inj ection before anesthesia,and C were those for no pre-expansion before anesthesia,three groups were no preoperative medication.We provided a brief observation of changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR), and neonatal Apgar score,the usage of nausea and vomiting and ephedrine among three groups of post-anes-thesia maternal.Results:Group A and B were lower than that of group C on the comparison in incidence of hypotension after anesthesia and the usage of ephedrine,which the difference was statistically significant (P<0.05).Group A of hemodynamic,moreover,were more stable than group B.There was no statistically sig-nificant difference between the three groups of Neonatal Apgar score (P>0.05).Conclusion:Using liquid ex-pansion before cesarean section under epidural anesthesia can not only reduce the incidence rate of intraopera-tive hypotension and the usage of ephedrine,but also have no adverse effect on the newborn.The effect of colloid was better than that of crystalloid solution.