中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
14期
2089-2091
,共3页
黄伟波%王丰%莫家玲%包陈娟%覃之人
黃偉波%王豐%莫傢玲%包陳娟%覃之人
황위파%왕봉%막가령%포진연%담지인
麻黄碱%羟乙基淀粉%麻醉%剖宫产术%低血压
痳黃堿%羥乙基澱粉%痳醉%剖宮產術%低血壓
마황감%간을기정분%마취%부궁산술%저혈압
Ephedrine%Hetastarch%Anesthesia%Cesarean section%Hypotension
目的 探讨不同剂量麻黄碱联合羟乙基淀粉预扩容对预防腰硬联合麻醉剖宫产术低血压的效果.方法 选取足月单胎需行剖宫产术的产妇250例,简单随机化法分为对照组与观察组(观察组分A、B、C、D四组),每组50例.对照组输注复方乳酸钠注射液250 ml;观察四组均输注250 ml羟乙基淀粉,A组加麻黄碱5 mg、B组加10 mg、C组加15 mg、D组加20 mg.比较五组产妇手术期间收缩压(SBP)、心率(HR)、不良反应等情况.结果 A组SBP在麻醉完成后平卧(T1)、消毒(T2)、子宫复原(T5)时与麻醉操作前(T0)时比较下降较为明显[(111.8±17.18)mm Hg、(114.58±19.80)mmHg、(115.06±10.39)mmHg与(120.88±13.24) mm Hg,均P＜0.05],在T1、胎儿取出(T4)、缝皮(T6)时点与B、C、D组比较差异均有统计学意义[(111.8±17.18)mm Hg与(120.78±14.47) mm Hg、(118.56±14.25)mm Hg、(118.42±18.71) mm Hg,(125.58±14.45)mm Hg与(120.02±21.15)mm Hg、(115.92±17.56) mm Hg、(119.00±12.49) mm Hg,(118.08±9.09)mm Hg与(121.52±10.92) mm Hg、(116.04±11.61)mmHg、(124.98±9.16)mm Hg,均P＜0.05]；HR在T1、T5时与T0时比较稍有波动(P＜0.05),在T1、切皮(T3)、T4、T6时点与C、D组比较差异均有统计学意义[(82.92±19.55)次/min与(98.86±17.82)次/min、(96.72±17.91)次/min,(89.04±16.68)次/min与(92.10±16.55)次/min、(98.46±19.49)次/min,(87.56±17.13)次/min与(98.86±16.76)次/min、(88.58±19.22)次/min,(93.20±14.07)次/min与(98.80±11.69)次/min、(90.98±10.93)次/min,均P＜0.05].B组及C组手术全程SBP、HR较为平稳,且不良反应少；D组SBP虽然较为平稳,但HR在手术全程中明显增快(P＜0.05),且在T4、T6时点与B、C组比较差异有统计学意义(P＜0.01).结论 麻黄碱的适宜剂量是10～ 15 mg,联合羟乙基淀粉预扩容能维持患者循环稳定.
目的 探討不同劑量痳黃堿聯閤羥乙基澱粉預擴容對預防腰硬聯閤痳醉剖宮產術低血壓的效果.方法 選取足月單胎需行剖宮產術的產婦250例,簡單隨機化法分為對照組與觀察組(觀察組分A、B、C、D四組),每組50例.對照組輸註複方乳痠鈉註射液250 ml;觀察四組均輸註250 ml羥乙基澱粉,A組加痳黃堿5 mg、B組加10 mg、C組加15 mg、D組加20 mg.比較五組產婦手術期間收縮壓(SBP)、心率(HR)、不良反應等情況.結果 A組SBP在痳醉完成後平臥(T1)、消毒(T2)、子宮複原(T5)時與痳醉操作前(T0)時比較下降較為明顯[(111.8±17.18)mm Hg、(114.58±19.80)mmHg、(115.06±10.39)mmHg與(120.88±13.24) mm Hg,均P＜0.05],在T1、胎兒取齣(T4)、縫皮(T6)時點與B、C、D組比較差異均有統計學意義[(111.8±17.18)mm Hg與(120.78±14.47) mm Hg、(118.56±14.25)mm Hg、(118.42±18.71) mm Hg,(125.58±14.45)mm Hg與(120.02±21.15)mm Hg、(115.92±17.56) mm Hg、(119.00±12.49) mm Hg,(118.08±9.09)mm Hg與(121.52±10.92) mm Hg、(116.04±11.61)mmHg、(124.98±9.16)mm Hg,均P＜0.05]；HR在T1、T5時與T0時比較稍有波動(P＜0.05),在T1、切皮(T3)、T4、T6時點與C、D組比較差異均有統計學意義[(82.92±19.55)次/min與(98.86±17.82)次/min、(96.72±17.91)次/min,(89.04±16.68)次/min與(92.10±16.55)次/min、(98.46±19.49)次/min,(87.56±17.13)次/min與(98.86±16.76)次/min、(88.58±19.22)次/min,(93.20±14.07)次/min與(98.80±11.69)次/min、(90.98±10.93)次/min,均P＜0.05].B組及C組手術全程SBP、HR較為平穩,且不良反應少；D組SBP雖然較為平穩,但HR在手術全程中明顯增快(P＜0.05),且在T4、T6時點與B、C組比較差異有統計學意義(P＜0.01).結論 痳黃堿的適宜劑量是10～ 15 mg,聯閤羥乙基澱粉預擴容能維持患者循環穩定.
목적 탐토불동제량마황감연합간을기정분예확용대예방요경연합마취부궁산술저혈압적효과.방법 선취족월단태수행부궁산술적산부250례,간단수궤화법분위대조조여관찰조(관찰조분A、B、C、D사조),매조50례.대조조수주복방유산납주사액250 ml;관찰사조균수주250 ml간을기정분,A조가마황감5 mg、B조가10 mg、C조가15 mg、D조가20 mg.비교오조산부수술기간수축압(SBP)、심솔(HR)、불량반응등정황.결과 A조SBP재마취완성후평와(T1)、소독(T2)、자궁복원(T5)시여마취조작전(T0)시비교하강교위명현[(111.8±17.18)mm Hg、(114.58±19.80)mmHg、(115.06±10.39)mmHg여(120.88±13.24) mm Hg,균P＜0.05],재T1、태인취출(T4)、봉피(T6)시점여B、C、D조비교차이균유통계학의의[(111.8±17.18)mm Hg여(120.78±14.47) mm Hg、(118.56±14.25)mm Hg、(118.42±18.71) mm Hg,(125.58±14.45)mm Hg여(120.02±21.15)mm Hg、(115.92±17.56) mm Hg、(119.00±12.49) mm Hg,(118.08±9.09)mm Hg여(121.52±10.92) mm Hg、(116.04±11.61)mmHg、(124.98±9.16)mm Hg,균P＜0.05]；HR재T1、T5시여T0시비교초유파동(P＜0.05),재T1、절피(T3)、T4、T6시점여C、D조비교차이균유통계학의의[(82.92±19.55)차/min여(98.86±17.82)차/min、(96.72±17.91)차/min,(89.04±16.68)차/min여(92.10±16.55)차/min、(98.46±19.49)차/min,(87.56±17.13)차/min여(98.86±16.76)차/min、(88.58±19.22)차/min,(93.20±14.07)차/min여(98.80±11.69)차/min、(90.98±10.93)차/min,균P＜0.05].B조급C조수술전정SBP、HR교위평은,차불량반응소；D조SBP수연교위평은,단HR재수술전정중명현증쾌(P＜0.05),차재T4、T6시점여B、C조비교차이유통계학의의(P＜0.01).결론 마황감적괄의제량시10～ 15 mg,연합간을기정분예확용능유지환자순배은정.
Objective To evaluate the effects of different doses of ephedrine combined with hydroxyethyl starch as a volume preload for preventing hypotension in caesarean section before combined spinal and epidural anesthesia.Methods 250 pregnant wemen undergoing cesarean section were randomly allocated into the control group (n =50) and the observation group(n =200)(group was divided into A,B,C,D group,each group 50 cases).Control group preloaded Lactated Ringer's solution 250ml before CSEA.A group preloaded hydroxyethyl starch combined with 5mg ephedrine; B group preloaded hydroxyethyl starch combined with 10mg ephedrine.C group preloaded hydroxyethyl starch combined with 15mg ephedrine; D group preloaded hydroxyethyl starch combined with 15mg ephedrine.The parturient SBP,HR and untoward reaction were monitored in five experimental groups.Results Compared with T0 A group parturient SBP was lower at T1,T2,T5 [(111.8 ± 17.18)mm Hg,(114.58 ± 19.80)mm Hg,(115.06 ± 10.39) mum Hg vs (120.88 ± 13.24) mm Hg,all P ＜ 0.05)].Compared with B,C,D group,statistical differences were found at T1,T4,T6[(111.8 ± 17.18)mm Hg vs (120.78 ± 14.47)mm Hg,(118.56 ± 14.25)mm Hg,(118.42 ± 18.71)mm Hg.(125.58 ± 14.45) mm Hg vs (120.02 ±21.15)mm Hg,(115.92 ± 17.56)mm Hg,(119.00 ±12.49)mm Hg.(118.08 ±9.09)mm Hg vs (121.52 ± 10.92) mm Hg,(116.04 ± 11.61)mm Hg,(124.98 ± 9.16) mm Hg,all P ＜ 0.05].Compared with T0 parturient HR was undulation at T1,T5 (P ＜ 0.05).Compared with C,D group,statistical differences were found at T1,T3,T4,T6 [(82.92 ± 19.55) times/min vs (98.86 ±17.82)times/min,(96.72 ± 17.91) times/min.(89.04 ± 16.68) times/min vs (92.10 ± 16.55) times/min,(98.46 ± 19.49) times/min.(87.56 ± 17.13) times/min vs (98.86 ± 16.76) times/min,(88.58 ± 19.22) times/min.(93.20 ± 14.07) times/min vs (98.80 ± 11.69) times/min,(90.98 ± 10.93) times/min.all P ＜ 0.05].In B and C group,parturient SBP and HR were steady and the untoward reaction was very few.Although parturient SBP of D group was steady,but HR obviously fast during operation (P ＜ 0.05).Compared with B,C group,statistical differences were found at T4,T6 (P ＜ 0.01).Conclusion The optimum dose is 10 ～ 15 mg of ephedrine.It combined with hydroxyethyl starch as a volume preload can keep the stable of blood circulation.
