CAJ | 학술논문

目的：观察小剂量去氧肾上腺素预防剖宫产患者腰—硬联合麻醉后低血压的临床效果。方法将拟行剖宫产术的60例患者随机为A、B组各30例，采用腰—硬联合麻醉后，两组均给予液体同步负荷，A组同时应用去氧肾上腺素。观察两组麻醉前后平均动脉压（ MAP）和心率（ HR）变化及术中情况，记录不良反应发生情况，并于新生儿出生1、5 min进行Apger评分。结果麻醉前后A组MAP及两组HR变化平稳，P均＞0．05；B组MAP在麻醉10 min后下降，P＜0．05。 A组低血压发生率低于B组，新生儿出生1 min的Apgar评分高于B组，P均＜0．05。两组鞘内注药至胎儿娩出时间、手术时间、术中输液量及新生儿出生5 min 的 Apgar 评分比较， P 均＞0．05。结论小剂量去氧肾上腺素可有效预防剖宫产患者腰—硬联合麻醉后低血压的发生，且不良反应较小。
목적：관찰소제량거양신상선소예방부궁산환자요—경연합마취후저혈압적림상효과。방법장의행부궁산술적60례환자수궤위A、B조각30례，채용요—경연합마취후，량조균급여액체동보부하，A조동시응용거양신상선소。관찰량조마취전후평균동맥압（ MAP）화심솔（ HR）변화급술중정황，기록불량반응발생정황，병우신생인출생1、5 min진행Apger평분。결과마취전후A조MAP급량조HR변화평은，P균＞0．05；B조MAP재마취10 min후하강，P＜0．05。 A조저혈압발생솔저우B조，신생인출생1 min적Apgar평분고우B조，P균＜0．05。량조초내주약지태인면출시간、수술시간、술중수액량급신생인출생5 min 적 Apgar 평분비교， P 균＞0．05。결론소제량거양신상선소가유효예방부궁산환자요—경연합마취후저혈압적발생，차불량반응교소。
Objective To observe the clinical effects of low-dose of phenylephrine in prevention of hypotension after combined spinal-epidural anesthesia ( CSEA) in cesarean patients .Methods Sixty cases of cesarean patients ( ASA I-Ⅱ) were randomly divided into two groups with 30 cases in each group: phenylephrine group ( group A ) and control group (group B).After the CSEA, patients in the two groups all received the liquid coload .For group A, phenylephrine was in-jected within 15 min.The changes of mean arterial pressure ( MAP) and heart rate ( HR) in the two groups were observed and compared before and after anesthesia .At the same time, complications, such as fidget, shiver and vomiting were also recorded.Newborns 1 min and 5min Apgar scores were estimated.Results MAPs in the group A, and HR of the two groups before and after anesthesia were stable (all P>0.05), while MAP was reduced in the group B 10 min after anesthe-sia (P<0.05).The incidence of hypotension was significantly lower , and neonatal 1 min Asgar scores were higher in group A than those of group B (all P<0.05).However, there were no differences in the time from intrathecal injection of medicine to fetal childbirth , operation time, intraoperative infusion and neonatal 5 min Apgar scores between two groups (all P>0.05).Conclusion Low-dose of phenylephrine could effectively prevent hypotension of cesarean patients after CSEA and has a few obvious adverse reactions .