腰麻剖宫产术中不同速度泵注催产素对产妇血压心率和产后出血等的影响.docVIP

腰麻剖宫产术中不同速度泵注催产素对产妇血压心率和产后出血等的影响 徐一刚 【摘要】目的:观察腰麻剖腹产术中以不同速度泵注催产素对产妇血压心率和产后出血等的影响。方法：选择择期剖宫产手术的产妇120例，ASA分级Ⅰ～Ⅱ级，根据催产素在术中的泵注速度，将催产素10U稀释到10ml随机分成3组，A组（1U /min），B组（0.5U /min），C组（0.33U /min）。产妇开通静脉，于腰硬联合麻醉后剖腹产，胎儿娩出断脐后，泵注催产素。每3分钟记录一次泵注催产素时产妇的血压、心率。记录子宫收缩张力，产后出血和不良反应。结果：三组患者的收缩压变化之间比较没有差异，在T6(18min）-T10（30min）时段，A组和B组的舒张压明显低于C组（P0.05)，A组和B组的心率在T1(3min)、T2(6min)、T4(12min)、T7(min)-T10(30min)时段均高于C组（P0.05)。产后出血和使用米索的情况三组之间的差异比较没有统计学意义。A组和B组的不良反应明显多于C组（P0.05)。结论:本研究结果提示剖宫产术中缓慢泵注催产素有利于产妇的循环稳定和减少催产素相关不良反应的发生。 【关键词】剖宫产；催产素；循环；产后出血；不良反应 The effect of different Oxytocin injection rate on hemodynamics in selective cesarean section undergoing spinal anesthesia 【Abstract】Objective: To investigate the effect of different oxytocin injection rate of on hemodynamics during cesarean section undergoing spinal anesthesia .Methods: 120 ASAⅠ—Ⅱparturient undergoing selective cesarean section were enrolled and divided into three groups according to oxytocin injection rate: group A (1U /min），group B（0.5U /min），group C （0.33U /min）.Each parturient received 10 U oxytocin after umbilical cord occlusion. The blood pressure and heart rate were recorded every 3 minutes. The uterus tension,postpartum hemorrhage and adverse effect were also recorded. Result: Compared with baseline ,there was no difference in SBP after oxytocin administration. DBP in group A and group B at T6 (18 min) - T10 (30 min) was lower than those in group C. Heart rate in group A and group B in each time period was higher than that of group C. The adverse effect in group A and group B were more than that in group C. There was no significant difference in postpartum hemorrhage and need for additional uterotonics among the three groups. Conclusion: Slow injection of oxytocin during cesarean section is better to maintain maternal hemodynamics and reduces oxytocin-related adverse reactions. 【keywords】cesarean section； Oxytocin； circulation；postpartum hemorrhage； adverse effect 催产素常规在剖腹产术中应用，以加强宫缩和预防产后出血。术中快速滴注催产素可以引起产妇低血压，心率加快，甚