中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
23期
41-43
,共3页
去氧肾上腺素%腰硬联合麻醉%剖宫产%循环稳定
去氧腎上腺素%腰硬聯閤痳醉%剖宮產%循環穩定
거양신상선소%요경연합마취%부궁산%순배은정
Phenylephrine%Combined spinal-epidural snesthesia%Cesarean Section%Stability of Circulation
目的：观察用微量泵持续静脉推注去氧肾上腺素对腰-硬联合麻醉下剖宫产术中血液循环稳定的影响。方法：选择100例择期剖宫产产妇，随机分为F组（在鞘内注局麻药即刻以25~100μg/min静脉泵入去氧肾上腺素维持循环稳定）和M组（根据血压下降程度，静注麻黄碱5 mg）。记录麻醉后多时点的血压，心率，恶心、呕吐发生情况，失血量，输液量，新生儿生后Apgar评分情况，胎儿娩出即刻脐静脉血血气分析指标。结果：F组各时点观察指标均优于M组（P<0.05），与麻醉前比较差异无统计学意义（P>0.05）；M组各时点血压与麻醉前比较差异有统计学意义（P<0.05），心率在麻醉后5 min时减慢（P<0.05）；F组脐静脉血气pH值、BE值均高于M组（P<0.05），PaCO2低于M组（P<0.05）；F组恶心、呕吐率低于M组（P<0.05）。结论：以25~100μg/min静脉泵入去氧肾上腺素，更能稳定腰-硬联合麻醉下剖宫产术中产妇的血液循环。
目的：觀察用微量泵持續靜脈推註去氧腎上腺素對腰-硬聯閤痳醉下剖宮產術中血液循環穩定的影響。方法：選擇100例擇期剖宮產產婦，隨機分為F組（在鞘內註跼痳藥即刻以25~100μg/min靜脈泵入去氧腎上腺素維持循環穩定）和M組（根據血壓下降程度，靜註痳黃堿5 mg）。記錄痳醉後多時點的血壓，心率，噁心、嘔吐髮生情況，失血量，輸液量，新生兒生後Apgar評分情況，胎兒娩齣即刻臍靜脈血血氣分析指標。結果：F組各時點觀察指標均優于M組（P<0.05），與痳醉前比較差異無統計學意義（P>0.05）；M組各時點血壓與痳醉前比較差異有統計學意義（P<0.05），心率在痳醉後5 min時減慢（P<0.05）；F組臍靜脈血氣pH值、BE值均高于M組（P<0.05），PaCO2低于M組（P<0.05）；F組噁心、嘔吐率低于M組（P<0.05）。結論：以25~100μg/min靜脈泵入去氧腎上腺素，更能穩定腰-硬聯閤痳醉下剖宮產術中產婦的血液循環。
목적：관찰용미량빙지속정맥추주거양신상선소대요-경연합마취하부궁산술중혈액순배은정적영향。방법：선택100례택기부궁산산부，수궤분위F조（재초내주국마약즉각이25~100μg/min정맥빙입거양신상선소유지순배은정）화M조（근거혈압하강정도，정주마황감5 mg）。기록마취후다시점적혈압，심솔，악심、구토발생정황，실혈량，수액량，신생인생후Apgar평분정황，태인면출즉각제정맥혈혈기분석지표。결과：F조각시점관찰지표균우우M조（P<0.05），여마취전비교차이무통계학의의（P>0.05）；M조각시점혈압여마취전비교차이유통계학의의（P<0.05），심솔재마취후5 min시감만（P<0.05）；F조제정맥혈기pH치、BE치균고우M조（P<0.05），PaCO2저우M조（P<0.05）；F조악심、구토솔저우M조（P<0.05）。결론：이25~100μg/min정맥빙입거양신상선소，경능은정요-경연합마취하부궁산술중산부적혈액순배。
To observe the stability of blood circulation during the operation of cesarean section under combined spinal-epidural anesthesia being maintained through keeping intravenous injection of phenylephrine using micro pump.Method:100 patients undergoing elective cesarean section were randomly divided into group F(intrathecal injection of local anesthetic in order to 25-100μg/min immediate intravenous infusion of phenylephrine to maintain loop stability)and group M(according to the degree of decrease in blood pressure,intravenous ephedrine 5 mg). The blood pressure,heart rate,the occurrence of nausea and vomit,bleeding volume,transfusion volume and the Apgar index for the new born at multiple time points after anesthesia were measured. Also,the blood gas analytical indexes of the blood taken from umbilical vein upon the moment the baby delivered were measured.Result:All measure indexes for group F at different time points were better than those of group M(P<0.05);compared with pre-anesthesia ,there were no statistical differences(P>0.05).In group M,compared with pre-anesthesia state,there were statistical differences in blood pressure at different time points(P<0.05);heart rate was lowed at 5 minute after enesthesia(P<0.05).The pH value and BE value of group F reported upon blood gas analysis tested on the blood taken from umbilical vein were higher than those of group M(P<0.05);PaCO2 of group F was lower than that of group M(P<0.05);nausea and vomiting rate of group F was lower than that of group M(P<0.05). Conclusion:Intravenous injection of phenylephrine at a speed of 25-100μg/min using micro pump helps the stabilization of blood circulation of a puerpera during the operation of cesarean section under combined spinal-epidural anesthesia.
