静脉滴注麻黄素预防剖腹产腰麻后低血压的临床研究.docVIP

静脉滴注麻黄素预防剖腹产腰麻后低血压的临床研究 【关键词】 麻黄素;剖宫产；腰麻-硬膜外麻醉联合麻醉;低血压 　　［摘 要］ 目的：研究在麻醉前静脉滴注小剂量麻黄素预防剖腹产腰麻后低血压。 方法：选择在腰麻-硬膜外麻醉联合麻醉下行剖宫产的产妇60例, ASAⅠ级～Ⅱ级,随机分成两组: 观察组(Ⅰ组)、对照组(Ⅱ组)每组30例。Ⅰ组麻醉前开放静脉通路, 麻黄素10 mg加入500 ml平衡液中静脉滴注，Ⅱ组仅用平衡液静脉滴注，按10 ml/kg于25 min～30 min内进行扩容。记录两组产妇麻醉前(T0)、麻醉后5 min(T1)、麻醉后10 min(T2)、麻醉后20 min(T3)和麻醉后30 min(T4)各时点的SBP 和HR的变化，以及低血压、恶心、呕吐等并发症的发生情况，记录胎儿出生后的Apgar评分。 结果：与T0时比较，Ⅰ组T1～T2时SBP下降(P＜0.05)，Ⅱ组T1～T3时SBP均下降，其中T1～T2时差异有显著性(P＜0.01)，T3时差异有显著性(P＜0.05)；与Ⅰ组比较，T1～T3时Ⅱ组SBP下降明显(P＜0.05)；两组麻醉后HR均有所增快，与T0相比差异无显著性，两组之间比较亦差异无显著性；两组低血压和恶心、呕吐的发生率两组相比差异有显著性(P＜0.05)，新生儿Apgar评分两组差异无显著性。结论：麻醉前预先静脉滴注麻黄素10 mg能够预防剖腹产腰麻后低血压的发生，减少恶心、呕吐和心动过缓等并发症。 　　［关键词］ 麻黄素;剖宫产；腰麻-硬膜外麻醉联合麻醉;低血压 　　Preventive Effect of Ephedrine on Hypotension In Caesarean Section Patients 　　ZENG Zhenping 　　(Meizhou Peoples Hospital, Meizhou， Guangzhou 5140031， China) 　　Abstract: Objective To observe the effect ofephedrine ,for prevention ofhypotension in caesarean section patients. Methods 60 ASAⅠ～Ⅱ patientsundergoing caesarean section with spinalepidural anesthesia, were randomly divided into two groups with 30 cases each: observation group(groupⅠ) and control group(group Ⅱ). 10 mg of ephedrine for group Ⅰ and 1 ml of normal saline for groupⅡ were ad ministered before anesthesia was given by intravenous drip. The systolic blood pressure(SBP) , heart rate(HR) , nausea and vomiting rate, Apgar score were recorded after anesthesia. Results SBP decreased significantly at T1 and T2 in group Ⅰ(Plt;0.05), SBP also decreased in group Ⅱ,there are very significantly difference at T1 and T2 (Plt;0.01),and significantly difference at T3 compare with those at T0;Compared with groupⅠ, SBP decreased significantly at T1 ，T2 and T3 in groupⅡ(Plt;0.05);HR increased after anesthesia in two groups, but the change was not remarkable compare with T0, and there were no significantly difference between two groups;The hypotension nausea and vomiting rate was significantly lower in group Ⅰ compare with i