中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
8期
1193-1195
,共3页
剖宫产术%麻醉%麻黄碱%多巴胺
剖宮產術%痳醉%痳黃堿%多巴胺
부궁산술%마취%마황감%다파알
Cesarean section%Anesthesia%Ephedrine%Dopamine
目的：比较剖宫产手术时，麻黄碱和多巴胺在预防腰硬联合麻醉下发生低血压的效果，并评价两种药物对母体和对胎儿的影响。方法将103例ASAⅠ或Ⅱ级择期在腰硬联合麻醉下行剖宫产的产妇分成两组，麻黄碱组（51例）预防性应用麻黄碱10 mg静脉注射，多巴胺组（52例）应用多巴胺5μg·kg－1· min－1静脉泵入。观察产妇不良反应、评价新生儿出生后1 min及5 min的Apgar评分，同时行脐动、静脉血气分析。结果麻黄碱组低血压发生率为43．1％，低于多巴胺组的69．2％（χ2＝7．06，P＝0．00）；麻黄碱组胎儿脐动脉血pH值（7．22±0．03），低于多巴胺组的（7．27±0．06）（t＝0．62，P＝0．02）；麻黄碱组新生儿出生后1 min判定为新生儿窒息者有16例，明显高于多巴胺组的6例（χ2＝5．79，P＝0．01，OR＝1．68，95％ CI＝1．18～2．41），脐静脉血pH值及新生儿5 min Apgar评分≤7分者两组差异均无统计学意义。结论麻黄碱较多巴胺更能有效预防腰硬联合麻醉下剖宫产产妇低血压的发生，但多巴胺对胎儿影响较小。
目的：比較剖宮產手術時，痳黃堿和多巴胺在預防腰硬聯閤痳醉下髮生低血壓的效果，併評價兩種藥物對母體和對胎兒的影響。方法將103例ASAⅠ或Ⅱ級擇期在腰硬聯閤痳醉下行剖宮產的產婦分成兩組，痳黃堿組（51例）預防性應用痳黃堿10 mg靜脈註射，多巴胺組（52例）應用多巴胺5μg·kg－1· min－1靜脈泵入。觀察產婦不良反應、評價新生兒齣生後1 min及5 min的Apgar評分，同時行臍動、靜脈血氣分析。結果痳黃堿組低血壓髮生率為43．1％，低于多巴胺組的69．2％（χ2＝7．06，P＝0．00）；痳黃堿組胎兒臍動脈血pH值（7．22±0．03），低于多巴胺組的（7．27±0．06）（t＝0．62，P＝0．02）；痳黃堿組新生兒齣生後1 min判定為新生兒窒息者有16例，明顯高于多巴胺組的6例（χ2＝5．79，P＝0．01，OR＝1．68，95％ CI＝1．18～2．41），臍靜脈血pH值及新生兒5 min Apgar評分≤7分者兩組差異均無統計學意義。結論痳黃堿較多巴胺更能有效預防腰硬聯閤痳醉下剖宮產產婦低血壓的髮生，但多巴胺對胎兒影響較小。
목적：비교부궁산수술시，마황감화다파알재예방요경연합마취하발생저혈압적효과，병평개량충약물대모체화대태인적영향。방법장103례ASAⅠ혹Ⅱ급택기재요경연합마취하행부궁산적산부분성량조，마황감조（51례）예방성응용마황감10 mg정맥주사，다파알조（52례）응용다파알5μg·kg－1· min－1정맥빙입。관찰산부불량반응、평개신생인출생후1 min급5 min적Apgar평분，동시행제동、정맥혈기분석。결과마황감조저혈압발생솔위43．1％，저우다파알조적69．2％（χ2＝7．06，P＝0．00）；마황감조태인제동맥혈pH치（7．22±0．03），저우다파알조적（7．27±0．06）（t＝0．62，P＝0．02）；마황감조신생인출생후1 min판정위신생인질식자유16례，명현고우다파알조적6례（χ2＝5．79，P＝0．01，OR＝1．68，95％ CI＝1．18～2．41），제정맥혈pH치급신생인5 min Apgar평분≤7분자량조차이균무통계학의의。결론마황감교다파알경능유효예방요경연합마취하부궁산산부저혈압적발생，단다파알대태인영향교소。
Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.
