医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2015年
1期
50-50
,共1页
盐酸甲氧明%腰麻%剖宫产%低血压
鹽痠甲氧明%腰痳%剖宮產%低血壓
염산갑양명%요마%부궁산%저혈압
Methoxamine hydrochloride%Lumbar anesthesia%Cesarean section%Hypotension
目的：观察盐酸甲氧明对剖宫产腰麻患者低血压的防治作用。方法选择180例腰麻下拟行剖宫产的患者,年龄18~40岁,ASA玉~Ⅱ级,随机分为6组(n=30)院A组在给予腰麻药物前后均未给任何药物,B组在给予腰麻药时肌注盐酸甲氧明0.1 mg/kg,C组在给予腰麻药后出现低血压时静注盐酸甲氧明0.05 mg/kg,D、E、F组分别在A、B、C组基础上预输注胶体8 ml/kg。经上述处理后,若血压仍明显偏低,则给予适量的麻黄碱。记录基础值和腰麻后5、10、15、20、25、30 min时的收缩压、舒张压、心率及麻黄碱总用量、恶心呕吐的发生率。结果与基础值比较,在腰麻后各时点,E组血压及心率平稳(>0.05),其余各组均出现血压下降、心率增快(<0.05)。与A组比较,其余各组麻黄碱总用量减少、恶心呕吐发生率降低(<0.05)；与E组比较,B、C、D组麻黄碱总用量增多、恶心呕吐发生率增高(<0.05)。结论对于腰麻下剖宫产术,预先肌注盐酸甲氧明并加以适当的胶体进行扩容治疗,可有效地防治术中的低血压,并可降低由低血压引起的恶心呕吐的发生率。
目的：觀察鹽痠甲氧明對剖宮產腰痳患者低血壓的防治作用。方法選擇180例腰痳下擬行剖宮產的患者,年齡18~40歲,ASA玉~Ⅱ級,隨機分為6組(n=30)院A組在給予腰痳藥物前後均未給任何藥物,B組在給予腰痳藥時肌註鹽痠甲氧明0.1 mg/kg,C組在給予腰痳藥後齣現低血壓時靜註鹽痠甲氧明0.05 mg/kg,D、E、F組分彆在A、B、C組基礎上預輸註膠體8 ml/kg。經上述處理後,若血壓仍明顯偏低,則給予適量的痳黃堿。記錄基礎值和腰痳後5、10、15、20、25、30 min時的收縮壓、舒張壓、心率及痳黃堿總用量、噁心嘔吐的髮生率。結果與基礎值比較,在腰痳後各時點,E組血壓及心率平穩(>0.05),其餘各組均齣現血壓下降、心率增快(<0.05)。與A組比較,其餘各組痳黃堿總用量減少、噁心嘔吐髮生率降低(<0.05)；與E組比較,B、C、D組痳黃堿總用量增多、噁心嘔吐髮生率增高(<0.05)。結論對于腰痳下剖宮產術,預先肌註鹽痠甲氧明併加以適噹的膠體進行擴容治療,可有效地防治術中的低血壓,併可降低由低血壓引起的噁心嘔吐的髮生率。
목적：관찰염산갑양명대부궁산요마환자저혈압적방치작용。방법선택180례요마하의행부궁산적환자,년령18~40세,ASA옥~Ⅱ급,수궤분위6조(n=30)원A조재급여요마약물전후균미급임하약물,B조재급여요마약시기주염산갑양명0.1 mg/kg,C조재급여요마약후출현저혈압시정주염산갑양명0.05 mg/kg,D、E、F조분별재A、B、C조기출상예수주효체8 ml/kg。경상술처리후,약혈압잉명현편저,칙급여괄량적마황감。기록기출치화요마후5、10、15、20、25、30 min시적수축압、서장압、심솔급마황감총용량、악심구토적발생솔。결과여기출치비교,재요마후각시점,E조혈압급심솔평은(>0.05),기여각조균출현혈압하강、심솔증쾌(<0.05)。여A조비교,기여각조마황감총용량감소、악심구토발생솔강저(<0.05)；여E조비교,B、C、D조마황감총용량증다、악심구토발생솔증고(<0.05)。결론대우요마하부궁산술,예선기주염산갑양명병가이괄당적효체진행확용치료,가유효지방치술중적저혈압,병가강저유저혈압인기적악심구토적발생솔。
Objective To study the ef ect of methoxamine hydrochloride on hypotension during cesarean section with lumbar anesthesia. Methods 180 patients undergoing cesarean section with lumbar anesthesia, aged 18~40 years old, ASAⅠ~II, were randomly divided into 6 groups (n=30):Patients of group A were treated without drugs before and after lumbar anaesthetic given, patients of group B were injected intramuscularly with methoxamine hydrochloride at a dose of 0.1 mg/kg before lumbar anaesthetic given, patients of group C were injected intravenously with methoxamine hydrochloride at a dose of 0.05 mg/kg as soon as hypotension happened after lumbar anaesthetic given, and based on group A, B and C, patients of group D, E and F were pretreated respectively with col oidal solution at a dose of 8 ml/kg. After the above treatment, if blood pressure was stil low, the right amount of ephedrine was injected intravenously. Systolic pressure, diastolic pressure and heart rate were recorded for basic value, 5, 10, 15, 20, 25 and 30 min after lumbar anesthesia, total dose of ephedrine and the incidence of nausea and vomiting were determined. Results Compared to basic value, there was no statistic dif erence ( >0.05) in blood pressure and heart rate of group E, and blood pressure was lower, heart rate was higher ( <0.05) in the other groups at each time point after lumbar anesthesia. Compared to group A, total dose of ephedrine and the incidence of nausea and vomiting in the other groups were both lower ( <0.05);compared to group E, total dose of ephedrine and the incidence of nausea and vomiting in group B, C and D were both higher ( <0.05). Conclusion During cesarean section with lumbar anesthesia, previously intramuscular injection of methoxamine hydrochloride and accompanying with the right amount of col oidal solution to improve blood volume can prevent and cure hypotension during surgery, and low the incidence of nausea and vomiting induced by hypotension.
