胶体液预扩容预防腰硬联合麻醉下剖宫产手术低血压的临床观察.docVIP

精品论文 参考文献 胶体液预扩容预防腰硬联合麻醉下剖宫产手术低血压的临床观察 （四川省攀枝花市米易县人民医院麻醉科 四川攀枝花 617200） 　　【摘要】目的：分析胶体液预扩容预防腰硬联合麻醉下剖宫产手术低血压的临床价值。方法：此次研究对象来自于2015年3月-2016年5月我院妇产科收治的腰硬联合麻醉下进行剖宫产手术的产妇120例，根据预扩容输液种类的不同分为实验组（胶体液）与对照组（晶体液），比较两组预扩容效果。结果：麻醉后5、15分钟，两组产妇的心率都有所上升，血压都有所下降，实验组产妇术中低血压的发生率为10%，对照组为28.3%，实验组产妇术中麻黄素使用率13.3%，对照组为31.7%，且二者间的变化比较起来，存在一定的差异，Plt;0.05。结论：对剖宫产手术产妇在进行腰硬联合麻醉前采用胶体液预扩容，其对低血压的预防作用明显比晶体液预扩容强，有效的降低了术中低血压的发生率及麻黄素的使用率。 　　【关键词】胶体液预扩容；腰硬联合麻醉；剖宫产手术；低血压；临床观察 　　【中图分类号】R614 【文献标识码】A 【文章编号】1007-8231（2016）25-0020-02 　　【Abstract】Objective To analyze the colloid volume expansion prevention clinical value of combined spinal and epidural anesthesia for cesarean section hypotension. Methods The subjects were from cesarean maternal March 2015 to May 2016 I was admitted to hospital maternity epidural anesthesia 120 cases, according to the different types of pre-infusion expansion divided into experimental group (colloid) and the control group (liquid crystal) were compared pre-expansion effect. Results Anesthesia 5 minutes and 15 minutes later, two groups of mothers have increased heart rate, blood pressure has decreased, the occurrence of the experimental groups were intraoperative hypotension was 10% in the control group was 28.3%, the experimental groups were surgery the prime jute usage 13.3% in the control group was 31.7%, and the variation between the two comparison, there are some differences, P lt;0.05. Conclusion The cesarean mothers during CSEA before using colloid pre-expansion, its preventive effect on blood pressure was significantly stronger than the liquid crystal pre-expansion, effectively reduce the incidence of intraoperative hypotension and ephedrine usage. 　　【Key words】Colloid volume expansion; Epidural anesthesia; Cesarean section; Hypotension; Clinical observation 　　腰硬联合麻醉由于麻醉起效快，肌松完善及可保证持续硬膜外麻醉效果，且有利于剖宫产术后镇痛等独特优势，而广泛应用于剖宫产手术中[1]。低血压是腰硬联合麻醉最严重且常见的一种并发症，临床研究发现[2]，约有85%的腰硬联合麻醉下剖宫产手术会发生低血压，并造成胎盘的灌注压下降。麻醉后低血压的发生不但会对产妇生命造成威胁，同时也会引起胎儿发生宫内