医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2014年
19期
121-122
,共2页
重度子痫前期患者%腰硬联合麻醉%七氟醚%剖宫产
重度子癇前期患者%腰硬聯閤痳醉%七氟醚%剖宮產
중도자간전기환자%요경연합마취%칠불미%부궁산
severe preeclampsia%sevoflurane%combined spinal-epidural anesthesia%cesarean sec- tion
观察七氟醚吸入麻醉在重度子痫前期患者胎儿娩出前对产妇血流动力学的影响。方法：择期剖宫产术的重度子痫前期产妇40例，平均分为二组， C组选择联合阻滞麻醉，S组选择七氟醚吸入麻醉。记录患者麻醉前、麻醉后2、5、8、10min及胎儿娩出时的MAP、HR，同时记录麻醉开始至手术开始时间，手术开始至胎儿娩出的时间和子宫切开至胎儿娩出时间、血管活性药物应用量及新生儿1 min、5 min Apgar 评分。结果：母体术中HR变化，S组与C组麻醉后比较2min和10min有差异，母体术中MAP变化，S组与C组麻醉后5min有差异。二组麻醉开始至手术开始时间有差异。二组产妇在胎儿剖出前麻黄碱使用率和胎儿剖出前使用麻黄碱总量比较均有统计学差异。结论：七氟醚吸入麻醉用于重度子痫前期患者在胎儿娩出前血流动力学方面比联合阻滞麻醉更稳定，减少低血压发生率，降低血管活性药物在胎儿娩出前的使用，是一种相对安全可行的麻醉方式。
觀察七氟醚吸入痳醉在重度子癇前期患者胎兒娩齣前對產婦血流動力學的影響。方法：擇期剖宮產術的重度子癇前期產婦40例，平均分為二組， C組選擇聯閤阻滯痳醉，S組選擇七氟醚吸入痳醉。記錄患者痳醉前、痳醉後2、5、8、10min及胎兒娩齣時的MAP、HR，同時記錄痳醉開始至手術開始時間，手術開始至胎兒娩齣的時間和子宮切開至胎兒娩齣時間、血管活性藥物應用量及新生兒1 min、5 min Apgar 評分。結果：母體術中HR變化，S組與C組痳醉後比較2min和10min有差異，母體術中MAP變化，S組與C組痳醉後5min有差異。二組痳醉開始至手術開始時間有差異。二組產婦在胎兒剖齣前痳黃堿使用率和胎兒剖齣前使用痳黃堿總量比較均有統計學差異。結論：七氟醚吸入痳醉用于重度子癇前期患者在胎兒娩齣前血流動力學方麵比聯閤阻滯痳醉更穩定，減少低血壓髮生率，降低血管活性藥物在胎兒娩齣前的使用，是一種相對安全可行的痳醉方式。
관찰칠불미흡입마취재중도자간전기환자태인면출전대산부혈류동역학적영향。방법：택기부궁산술적중도자간전기산부40례，평균분위이조， C조선택연합조체마취，S조선택칠불미흡입마취。기록환자마취전、마취후2、5、8、10min급태인면출시적MAP、HR，동시기록마취개시지수술개시시간，수술개시지태인면출적시간화자궁절개지태인면출시간、혈관활성약물응용량급신생인1 min、5 min Apgar 평분。결과：모체술중HR변화，S조여C조마취후비교2min화10min유차이，모체술중MAP변화，S조여C조마취후5min유차이。이조마취개시지수술개시시간유차이。이조산부재태인부출전마황감사용솔화태인부출전사용마황감총량비교균유통계학차이。결론：칠불미흡입마취용우중도자간전기환자재태인면출전혈류동역학방면비연합조체마취경은정，감소저혈압발생솔，강저혈관활성약물재태인면출전적사용，시일충상대안전가행적마취방식。
To observe the effects of sevoflurane to MAP, HR in preeclampsia patients using cesarean section til the newborn delivery.Methods: 40 parturients with severe preeclampsia,ASAI-I I,for cesarean section were equal y into combine spinal-epidural anaesthesia group(C,n = 20) and sevoflurane inhalation anesthesia group(S, n = 20). MAP and HR were monitored at the time points of before anesthesia,2,5,8,10min after anesthesia and the moment of neonatus expulsion.The time from induction to striking skin,from striking skin to newborn deliver, from striking uterus to newborn deliver and the dosage of ephedrine was recorded. Apgar score of neonate was assessed. Results: The HR was decreased obviously at the time points of2,10 min .The MAP in group S was higher than that in group C at the time points of 5 min. The time from between induction and striking skin was decreased obviously .The dosage of ephedrine in group S was fewer then that in group C .Conclusion: It is an safe and effective measurement to stable maternal hemodynamics that sevoflurane inhalation anesthesia for cesarean section with severe preeclampsia to reduce the incidence of hypotension and dosage of ephedrine used til the newborn delivery .
