去氧肾上腺素、麻黄素对腰硬联合麻醉下剖宫产母婴的影响.pdfVIP

现代医院2010年 1月第lO卷第 1期 专 业 技 术 篇 Modem HospitalJan2010Vol10No1 61 去氧肾 ==【腺素、麻黄素对腰硬联合麻醉下剖宫产母婴的影响 骆智宇 莫惠飞 李 斌 EFFECTS OF PHENYLEPHRlN AND EPHEDRINE 0N FETUSESAND MATERSDURING COMBINED SPINAL—EPIDURALANESTHESIA FORCESAREAN DELIVERY LUOZhiyu，MOHuifei，LIBin 【摘 要】 目的 探讨和麻黄素相比，去氧肾上腺素用于腰硬联合麻醉下剖宫产。对母体和 新生儿的影响。方法 选择择期剖宫产术病人6o例，ASA I一Ⅱ级，随机分为两组。分别给予静 脉泵注去氧肾上腺素100 g／ml(P组)和麻黄素3rag／m1(E组)维持术 中收缩压在基础水平。记 录术中HR、BP、SpO、ECG，采集新生儿脐静脉、脐动脉血监测 pH、PO：、PCO：，记录产妇术中恶心、 呕吐发生率。结果 E组术中HR、RPP高于P组(p0．05)；P组新生儿脐静脉血pH、PO2高于E 组(P0．05)；P组术中恶心、呕吐发生率低 于E纽 (P0．05)。结论 和麻黄素相比，去氧 肾上腺 素用于维持腰硬联合麻醉下剖宫产患者的术中血压，能降低新生儿酸中毒的发生率和降低产妇术 中恶心、呕吐的发生率。 【关键词】 去氧肾上腺素 麻黄素 腰硬联合麻醉 剖宫产 新生儿酸中毒 【Abstract】 0bjective TostudytheeffectsofphenylephrineandephedrineonfetusesandMaters duringcombinedspinal—epidural naesthesiaforCesareanDelivery．M ethods SixtyASAI～IIpatients scheduledforselectiveCesraeflnsectionundercombinedspinal—-epiduralanesthesiaweredividedintotwo experimentalgroups．Itcomparedphenylephrine100 g／ml(phenylephrinegroupP)nadephedrine3 mr,／ml(ephedrinegroupE)，givenbyinfusion，tomaintainmaternalsystolicarterialpressureatbaseline duringcesarena delivery．HR，BP，SpO2nadECGwerecontinuouslymonitoredduringoperation．Blood samplesweretakenfrom umb ilicalartery nadveintodeterminePH，PO2，andPCO2．Maternalnauseanad vomitingwerealsocompared．Results TheHRnadRPPinEgroupwereincreasedduringoperation (p 0．05)．UmbilicalVenousPHnadVenousPO2inPgroupwereincreased(p0．05)．Maternalnausea andvomi tinginPgroupwerelowerhtenEgroup．Conclusion Givingphenylephrinealonebyinfusionat cesa1~andelivery wasassociatedwithalowerincidenceoffetal acidosisandmaternalnauseaandvomiting thangivingephedrinealone． K【eywords】Phenylephrine，Ephedrine，Combinedspinal—epiduralanesthesia，Cesareandeliv． cry ，Fetalacidosis 【Authorsaddress】 ShenzhenPeople’sHospitalofBaonaDistrict，GuangdongProvince518101 PRC doi：10．3969／j．issn．1671—332