中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
30期
53-55
,共3页
牛建录%王宏%吕平%韩红%裴晓龙
牛建錄%王宏%呂平%韓紅%裴曉龍
우건록%왕굉%려평%한홍%배효룡
剖宫产术%催产素%血压
剖宮產術%催產素%血壓
부궁산술%최산소%혈압
Cesarean section%Oxytocin%Blood pressure
目的 观察剖宫产术中输注不同剂量的缩宫素对产妇血压的影响.方法 选择行孕足月剖宫产的产妇60例,按随机数字表法分为A组、B组、C组,每组20例.三组均行连续硬膜外麻醉,胎儿娩出后均在子宫肌肉注射缩宫素10 U,继之A组5U、B组10U、C组20 U缩宫素加入500 ml乳酸钠林格注射液以10 ml/min的速度静脉输注,根据手术医师的判断,对子宫收缩不良者舌下含服0.2 mg米索前列醇,出现严重低血压者给予5 mg麻黄碱静脉注射,于麻醉前(T0)、胎儿娩出后(T1)及输注缩宫素后5 min(T2)、10 min(T3)、30 min(T4)记录平均动脉压(MAP)、心率以及麻黄碱和米索前列醇用量.结果 A组和B组各时间点MAP和心率比较差异无统计学意义(P＞0.05);C组T2和T3时MAP明显低于A组和B组,心率明显快于A组和B组,差异有统计学意义(P＜0.05).但A组有7例、B组有2例、C组有1例患者因子宫收缩不良而舌下含服米索前列醇0.2 mg;A组有1例、B组有3例、C组有8例患者因血压下降超过基础值20％而静脉注射麻黄碱5 mg.结论 剖宫产术中于胎儿娩出后在子宫肌肉注射缩宫素10U,继之将10U缩宫素加入500 ml乳酸钠林格注射液中以10 ml/min的速度静脉输注对产妇血压及心率的影响较小,并能达到满意的子宫收缩效果.
目的 觀察剖宮產術中輸註不同劑量的縮宮素對產婦血壓的影響.方法 選擇行孕足月剖宮產的產婦60例,按隨機數字錶法分為A組、B組、C組,每組20例.三組均行連續硬膜外痳醉,胎兒娩齣後均在子宮肌肉註射縮宮素10 U,繼之A組5U、B組10U、C組20 U縮宮素加入500 ml乳痠鈉林格註射液以10 ml/min的速度靜脈輸註,根據手術醫師的判斷,對子宮收縮不良者舌下含服0.2 mg米索前列醇,齣現嚴重低血壓者給予5 mg痳黃堿靜脈註射,于痳醉前(T0)、胎兒娩齣後(T1)及輸註縮宮素後5 min(T2)、10 min(T3)、30 min(T4)記錄平均動脈壓(MAP)、心率以及痳黃堿和米索前列醇用量.結果 A組和B組各時間點MAP和心率比較差異無統計學意義(P＞0.05);C組T2和T3時MAP明顯低于A組和B組,心率明顯快于A組和B組,差異有統計學意義(P＜0.05).但A組有7例、B組有2例、C組有1例患者因子宮收縮不良而舌下含服米索前列醇0.2 mg;A組有1例、B組有3例、C組有8例患者因血壓下降超過基礎值20％而靜脈註射痳黃堿5 mg.結論 剖宮產術中于胎兒娩齣後在子宮肌肉註射縮宮素10U,繼之將10U縮宮素加入500 ml乳痠鈉林格註射液中以10 ml/min的速度靜脈輸註對產婦血壓及心率的影響較小,併能達到滿意的子宮收縮效果.
목적 관찰부궁산술중수주불동제량적축궁소대산부혈압적영향.방법 선택행잉족월부궁산적산부60례,안수궤수자표법분위A조、B조、C조,매조20례.삼조균행련속경막외마취,태인면출후균재자궁기육주사축궁소10 U,계지A조5U、B조10U、C조20 U축궁소가입500 ml유산납림격주사액이10 ml/min적속도정맥수주,근거수술의사적판단,대자궁수축불량자설하함복0.2 mg미색전렬순,출현엄중저혈압자급여5 mg마황감정맥주사,우마취전(T0)、태인면출후(T1)급수주축궁소후5 min(T2)、10 min(T3)、30 min(T4)기록평균동맥압(MAP)、심솔이급마황감화미색전렬순용량.결과 A조화B조각시간점MAP화심솔비교차이무통계학의의(P＞0.05);C조T2화T3시MAP명현저우A조화B조,심솔명현쾌우A조화B조,차이유통계학의의(P＜0.05).단A조유7례、B조유2례、C조유1례환자인자궁수축불량이설하함복미색전렬순0.2 mg;A조유1례、B조유3례、C조유8례환자인혈압하강초과기출치20％이정맥주사마황감5 mg.결론 부궁산술중우태인면출후재자궁기육주사축궁소10U,계지장10U축궁소가입500 ml유산납림격주사액중이10 ml/min적속도정맥수주대산부혈압급심솔적영향교소,병능체도만의적자궁수축효과.
Objective To observe the effects of blood pressure by intravenous infusion of different doses ofoxytocin in cesarean section.Methods Sixty full-term pregnant women undergoing cesarean section with continuous epidural anesthesia were divided into three groups by random digits table method with 20 cases each:group A,B and C.Three groups were injected 10 U oxytocin in uterine muscle after infant delivery.Group A,B and C received 5,10 and 20 U oxytocin (sodium lactate ringer,500 ml) continuous intravenous infusion at the speed of 10 ml/min.If happened uterine contractions bad,they were sublingual administering 0.2 mg misoprostol.If happened severe hypotension,they were intravenous injected 5 mg ephedrine.The change of mean arterial pressure (MAP) and heat rate before anesthesia (T0),after fetal childbirth (T1),5 m in (T2),10 min (T3),30 min (T4) after infusion of oxytocin and the dosage of ephedrine and misoprostol were recorded.Results There were no significant differences in MAP and heart rate at every time point between group A and B (P＞ 0.05).MAP decreased and heart rate increased in group C at T2,T3 compared with those in group A and B,and there were significant differences (P＜ 0.05).The number of cases of sublingual misoprostol were increased in group A (7 cases) compared with that in group B (2 cases) and group C(1 case).The 8 patients injected ephedrine in group C were more than group A(1 case) and group B (3 cases).Conclusion Cesarean section after the delivery of the fetus in the uterus muscle injection of oxytocin 10 U,after 10 U of oxytocin added 500 ml sodium lactate ringer injection at the speed of 10 ml/min intravenous infusion has little effect on the blood pressure and heart rate,and has good uterine contractions.
