剖宫产术麻醉前用缩合葡萄糖液预扩容的临床效果观察..docVIP

剖宫产手术麻醉前用缩合葡萄糖液预扩容效果及安全性的临床观察 周幼珍 何妹仪 李丽 龚文魁 何建伟 （佛山市禅城中心医院麻醉科,广东,佛山,528031pH、Glu 、APTT、PT的变化，麻醉后使用麻黄素的病例、术后低血压病例及输液不良反应，麻醉时间和手术时间等。结果 麻醉后RL组MAP、HR变化的幅度与其麻醉前及PG组相比均具有显著性的差异（P＜0.01），扩容后PG组的Hct、pH、Glu、APTT、PT变化明显（P＜0.05或P＜0.01），但仍在正常范围内；麻醉后PG组低血压5例，RL组12例；术后发生低血压在PG组7例，RL组4例；全部病例均无发生过敏等不良反应。结论 剖宫产术病人使用缩合葡萄糖氯化钠注射液预扩容，能有效抵制腰—硬联合麻醉所产生的心血管变化，适量使用不会明显影响血液凝固和提升血糖。 关键词 剖宫产；缩合葡萄糖；预扩容；效果；安全性 Clinical observation of efficacy and security of pre-anesthetic hypervolemic hemodilution with polyglucose before cesarean section ZHOU Youzhen,HE meiyi,LI Li, et al(Department of Anesthesia of Chan-cheng Borough The Middle’s Hospital ,FOshan528031,Guangdong,P.R.China)Abstract Objective To observe the effects and security of pre-anesthetic hypervolemic hemodilution with polyglucose sodium chloride on patients taking cesarean section under combined spinal-epidural anesthesia. Methods 50 cases, generally good and will soon undertaking maternal cesarean section, were randomly divided into two groups, 25 cases for each, named as polyglucose sodium chloride injection (PG) group and compound sodium lactate (RL) group. The patients in the two groups were respectively injected with polyglucose sodium chloride and compound sodium lactate at a speed of 15 mL/kg.h-1. The changes of mean arterial pressure (MAP) and heart rate (HR) before and after pre-anesthetic hypervolemic hemodilution, 5 min, 10min, 15min, 20min after anesthesia, and the changes of Hct, pH, Glu, APTT, PT before and after pre-anesthetic hypervolemic hemodilution, and the cases had ephedrine after anesthesia, the cases with low postoperative blood pressure, infusion adverse reactions, anesthesia time and surgical time were also recorded and analyzed. Results The MAP and HR after anesthesia in RL groups were significantly different from that before anesthesia and that in PG group (P 0.01). After pre-anesthetic hypervolemic hemodilution, the Hct, pH, Glu, APTT, PT changed significantly (P 0.05 or 0.01), but still within normal r