CAJ | 학술논문

目的：观察右美托咪定和丙泊酚对剖宫产术中卡前列素氨丁三醇引起的不良反应的预防作用。方法选择2013年5-11月于本院拟在硬膜外麻醉下行择期剖宫产术且术中宫缩乏力而使用卡前列素氨丁三醇的孕妇93例，采用随机数字表法分为3组，右美托咪定组31例、丙泊酚组31例和对照组31例。右美托咪定组泵注右美托咪定1μg/kg，10 min后以0.4μg·kg-1·h-1持续静脉泵注；丙泊酚组泵注丙泊酚1 mg·kg-1·min-1，1 min后以3 mg· kg-1·h-1持续静脉泵注；对照组泵注0.9%氯化钠溶液，均持续至手术结束。监测3组产妇手术时间、术中输入量、术毕出血量，不同时间（麻醉前，使用卡前列素氨丁三醇10 min、20 min及术毕）血压、心率、呼吸及血氧饱和度（ SPO2），记录恶心、呕吐、胸腹痛、面部潮红及头痛等不良反应发生率。结果3组产妇手术时间、术中输入量、术毕出血量比较，差异均无统计学意义（P>0.05）。3组SBP组间比较，差异有统计学意义（P<0.05）；DBP时间间比较，差异有统计学意义（P<0.05）；心率时间及交互间比较，差异有统计学意义（P<0.05）；呼吸和SPO2组间、时间、交互间比较，差异均无统计学意义（P>0.05）。丙泊酚组较对照组恶心、呕吐发生率降低（P<0.05）；右美托咪定组无恶心、呕吐发生。丙泊酚组和右美托咪定组较对照组，丙泊酚组较右美托咪定组胸痛、腹痛、面部潮红发生率降低（P<0.05）；丙泊酚组和右美托咪定组均无头痛发生。结论右美托咪定和丙泊酚均可有效减少剖宫产术中卡前列素氨丁三醇注射液所产生的血流动力学波动和身体不良反应。
목적：관찰우미탁미정화병박분대부궁산술중잡전렬소안정삼순인기적불량반응적예방작용。방법선택2013년5-11월우본원의재경막외마취하행택기부궁산술차술중궁축핍력이사용잡전렬소안정삼순적잉부93례，채용수궤수자표법분위3조，우미탁미정조31례、병박분조31례화대조조31례。우미탁미정조빙주우미탁미정1μg/kg，10 min후이0.4μg·kg-1·h-1지속정맥빙주；병박분조빙주병박분1 mg·kg-1·min-1，1 min후이3 mg· kg-1·h-1지속정맥빙주；대조조빙주0.9%록화납용액，균지속지수술결속。감측3조산부수술시간、술중수입량、술필출혈량，불동시간（마취전，사용잡전렬소안정삼순10 min、20 min급술필）혈압、심솔、호흡급혈양포화도（ SPO2），기록악심、구토、흉복통、면부조홍급두통등불량반응발생솔。결과3조산부수술시간、술중수입량、술필출혈량비교，차이균무통계학의의（P>0.05）。3조SBP조간비교，차이유통계학의의（P<0.05）；DBP시간간비교，차이유통계학의의（P<0.05）；심솔시간급교호간비교，차이유통계학의의（P<0.05）；호흡화SPO2조간、시간、교호간비교，차이균무통계학의의（P>0.05）。병박분조교대조조악심、구토발생솔강저（P<0.05）；우미탁미정조무악심、구토발생。병박분조화우미탁미정조교대조조，병박분조교우미탁미정조흉통、복통、면부조홍발생솔강저（P<0.05）；병박분조화우미탁미정조균무두통발생。결론우미탁미정화병박분균가유효감소부궁산술중잡전렬소안정삼순주사액소산생적혈류동역학파동화신체불량반응。
Objective To study the effect of dexmedetomidine and propofol in the prevention of adverse reaction caused by carboprost tromethamine in cesarean section. Methods 93 primigravida received cesarean section with epidural anes-thesia in our hospital from May to November in 2013 were given carboprost tromethamine due to uterine inertia. The patients were randomly divided into dexmedetomidine group( 31 cases ), propofol group( 31 cases ) and control group( 31 cases ) . The dexmedetomidine group was given dexmedetomidine injection of 1 μg/kg,and was then given continuous intravenous injection of dexmedetomidine by 0. 4 μg·kg-1·h-1. The propofol group was given propofol injection of 1 mg·kg-1·min-1,and was then given continuous intravenous injection of propofol by 3 mg·kg-1·h-1. The control group was given saline injection until the end of the operation. The operation time,injection volume,bleeding volume,BP,HR,RR and SPO2 of the three groups were mo-nitored,and adverse reaction like nausea,vomiting,chest and abdominal pain,flush and headache were recorded. Results The operation time,injection volume and bleeding volume among the three groups showed no statistically significant difference( P>0. 05). The SBP,DBP,HR among the three groups showed statistically significant differences(P <0. 05),but RR and SPO2 among the three groups showed no statistically significant difference(P>0. 05). Compared with the control group,the in-cidence of nausea and vomiting was lower in propofol group(P<0. 05). Nausea and vomiting did not occur in the dexmedetomi-dine group. Compared with the control group and dexmedetomidine group,the incidence of chest and abdominal pain and flush in propofol group was lower(P<0. 05). Headache did not occur in the propofol group and dexmedetomidine group. Conclusion Dexmedetomidine and propofol can effectively reduce the hemodynamic fluctuations and adverse reactions generated by carboprost tromethamine in cesarean section.