预注小剂量肾上腺素对剖宫产术中低血压及母婴安全性的影响

发布时间：2018-06-01 11:56

本文选题：肾上腺素 + 低血压　；参考：《中国药房》2015年09期

【摘要】：目的:观察预注小剂量肾上腺素对剖宫产术中低血压及母婴安全性的影响。方法:60例择期行剖宫产术产妇随机均分为观察组和对照组。观察组患者在麻醉同时,持续静脉泵注肾上腺素0.02~0.03μg/(kg·min),直到胎儿取出后停用肾上腺素;对照组患者以0.02~0.03μg/(kg·min)持续泵注0.9%氯化钠注射液。观察两组产妇的麻醉平面、麻黄碱使用量,麻醉前(T1)、注射腰麻药物后5 min(T2)、注射腰麻药物后15 min(T3)、注射腰麻药物后30 min(T4)以及术毕(T5)时的心率(HR)、平均动脉压(MAP);记录两组新生儿1 min及5 min的阿普加(Apgar)评分、HR、静脉血血气指标{新生儿脐静脉血的p H、氧分压[p(O2)]、二氧化碳分压[p(CO2)]、碱剩余值(BE)、碳酸氢根离子浓度(HCO3-1)}和不良反应发生情况。结果:两组产妇麻醉平面、新生儿1 min及5 min的Apgar评分、HR、p(CO2)、BE、HCO3-1比较,差异均无统计学意义(P0.05),而观察组产妇麻黄碱使用量、总不良反应发生率显著低于对照组,观察组新生儿p H、p(O2)均显著高于对照组,差异均有统计学意义(P0.05)。两组产妇T1时的MAP、HR比较,差异均无统计学意义(P0.05);观察组产妇T1~5各时间点的MAP比较,差异均无统计学意义(P0.05),对照组产妇T2~5各时间点的MAP显著低于同组T1时,且观察组T2~4时高于对照组T2~4时;对照组产妇T1~5时HR比较,差异均无统计学意义((P0.05),观察组T2、T4时HR显著高于同组T1时,且高于对照组,差异均有统计学意义(P0.05)。结论:预注小剂量肾上腺素对剖宫产术中低血压有防治作用,有利于维持胎儿酸碱平衡的稳定和提供足够氧供,且安全性较好。
[Abstract]:Objective: to observe the effect of low-dose epinephrine on hypotension and maternal and infant safety during cesarean section. Methods 60 cases of cesarean section were randomly divided into observation group and control group. At the same time of anesthesia, the patients in the observation group were continuously injected with 0.02U 0.03 渭 g/(kg of epinephrine until fetuses were removed, while the patients in the control group were continuously injected with 0.9% sodium chloride injection by 0.02-0.03 渭 g/(kg. The anesthesia level and ephedrine usage were observed in the two groups. Before anesthesia, 5 minutes after injection of spinal anesthetic, 15 minutes after injection of spinal anesthetic, 30 minutes after injection of spinal anaesthesia, and 30 minutes after operation, the heart rate and mean arterial pressure were measured. The Apgar scores of 1 min and 5 min of newborns in both groups were recorded. The blood gas index {pH, partial pressure of oxygen, partial pressure of carbon dioxide, residual value of alkali, HCO _ 3-1} and adverse reactions occurred in umbilical vein blood of newborn (P _ 2O _ 2), CO _ (2) and CO _ (2) (P _ (2) O _ (2), the residual value of alkali, the concentration of bicarbonate ion (HCO _ 3-1)}, respectively. Results: there was no significant difference in anesthesia level, Apgar score of 1 min and 5 min Apgar score between the two groups (P 0.05), while the incidence of total adverse reactions in the observation group was significantly lower than that in the control group. Compared with the control group, the newborns in the observation group were significantly higher than those in the control group (P 0.05). There was no significant difference in MAP between the two groups at T1, while the MAP of the control group was significantly lower than that of the control group at T _ 1, P _ (0.05), P _ (0.05) and T _ (1) T _ (5) at all time points in the observation group, but there was no significant difference between the two groups at each time point of T _ 1 / T _ (5), and there was no significant difference in MAP between the two groups. There was no significant difference in T _ 1 ~ 5 HR between control group and control group (P < 0.05). The HR at T _ 2 T _ 4 in observation group was significantly higher than that in T _ 1 and T _ 1 in observation group, and the difference was statistically significant (P 0.05). Conclusion: preinjection of small dose of epinephrine can prevent and cure hypotension during cesarean section, which is beneficial to maintain the stability of fetal acid-base balance and provide adequate oxygen supply, and is safe.
【作者单位】：达州市中心医院麻醉科;
【分类号】：R614

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