CAJ | 학술논문

目的：研究预注甲氧胺复合麻黄碱对剖宫产术腰－硬联合麻醉低血压的预防效果及安全性。方法150例择期剖宫产术孕产妇随机分为3组（n＝50）。对3组患者静脉预注升压药物：A组患者给予甲氧胺4mg，B组患者给予麻黄碱10mg，C组患者给予甲氧胺2mg＋麻黄碱5mg。监测并比较各组患者麻醉前后收缩压（SBP）、心率（HR）、不良反应情况及新生儿脐动脉血pH、1分钟和5分钟Apgar评分。结果3组SBP差异无显著性，麻醉预注后10分钟、15分钟时B组HR明显比A组快（P＜0．05），C组HR最为平稳。总体不良反应C组显著少于B组（ P＜0．05），A、C两组新生儿脐动脉血pH显著高于B组（ P＜0．05），3组新生儿1分钟和5分钟Apgar评分比较差异无显著性。结论甲氧胺复合麻黄碱预防剖宫产术患者腰－硬联合麻醉低血压安全、有效，且能够使患者心率更加平稳，新生儿酸碱平衡更加稳定，值得临床推广应用。
목적：연구예주갑양알복합마황감대부궁산술요－경연합마취저혈압적예방효과급안전성。방법150례택기부궁산술잉산부수궤분위3조（n＝50）。대3조환자정맥예주승압약물：A조환자급여갑양알4mg，B조환자급여마황감10mg，C조환자급여갑양알2mg＋마황감5mg。감측병비교각조환자마취전후수축압（SBP）、심솔（HR）、불량반응정황급신생인제동맥혈pH、1분종화5분종Apgar평분。결과3조SBP차이무현저성，마취예주후10분종、15분종시B조HR명현비A조쾌（P＜0．05），C조HR최위평은。총체불량반응C조현저소우B조（ P＜0．05），A、C량조신생인제동맥혈pH현저고우B조（ P＜0．05），3조신생인1분종화5분종Apgar평분비교차이무현저성。결론갑양알복합마황감예방부궁산술환자요－경연합마취저혈압안전、유효，차능구사환자심솔경가평은，신생인산감평형경가은정，치득림상추엄응용。
Objective To research the preventice effect and safety of methoxamine and ephedrine on combined spinal -epidural anesthesia-associated hypotension in patients with ce sareansection.Methods 150 patients undergoing cesarean section were randomLy divided into three groups ( n=50).Three groups were given intravenous injection with hypertensors:methoxamine(4mg)was given to A group,ephedrine(10mg)was given to B group,methoxamine(2mg)and ephedrine(5mg) was given to C group.The systobic blood pressure ( SBP)、heart rate ( HR)、adverse reactions and umbilical arterty blood pH、Apgar at 1min and 5min of newborn were checked and compared .Results The SBP of the three groups had no signifi-cant difference.The HR of the B group at 10min and 15min after anesthesia injection were significantly faster than that of A group( P<0.05 ) ,and that of C group was the most stable .The adverse reactions of C group was significantly less than that of B group(P<0.05),the umbilical arterty blood pH of newborn of A and C group were significantly higher than that of B (P<0.05),the Apgar at 1min and 5min of newborn had no significant difference.Conclusion Using methoxamine and ephedrine on combined spinal-epidural anesthesia-associated hypotension in patients with cesarean section is safe and effec-tive,and it is helpful to stabling HR and the acid-base balance of the newborn which is worthy to recommand its clinical use .