七氟醚对重度子痫前期患者血流动力学影响的临床观察.docx

七氟醛对重度子痫前期患者血流动力学影响的临床观察 蔡恒宇郁红艳 (沈阳市妇婴医院麻醉科辽宁沈阳110000) 【摘要】目的：观察七氟醸吸入麻醉在重度子痫前期患者胎儿娩出前 对产妇血流动力学的影响。方法：择期剖宫产术的重度子痫前期产妇40例，平 均分为二组，C组选择联合阻滞麻醉，S组选择七氟醸吸入麻醉。记录患者麻醉 前、麻醉后2、5、8> lOmin及胎儿娩出时的MAP、HR,同时记录麻醉开始至手 术开始时间，手术开始至胎儿娩出的时间和子宫切开至胎儿娩出时间、血管活性 药物应用量及新生儿1 min、5 min Apgar评分。结果：母体术中HR变化，S组 与C组麻醉后比较2min和lOmin有差异,母体术中MAP变化，S组与C组麻醉 后5min有差异。二组麻醉开始至手术开始时间有差异。二组产妇在胎儿剖出前 麻黄碱使用率和胎儿剖出前使用麻黄碱总量比较均有统计学差异。结论：七氟瞇 吸入麻醉用于重度了痫前期患者在胎儿娩出前血流动力学方面比联合阻滞麻醉 更稳定，减少低血压发生率，降低血管活性药物在胎儿娩出前的使用，是一种相 对安全可行的麻醉方式。 【关键词】重度子痫前期患者腰硬联合麻醉七氟醸剖宫产 【中图分类号】R614 【文献标识码】A 【文章编号】2095-1752 (2014) 19-0121-02 A Clinical Observation :The effects of sevoflurane to Hemodynamic Changes in Preeclampsia Patients using Cesarean Section CAI Heng-yu GAO Hongyan(Department of Anesthesiology, Shenyang Women’s and Children’s Hospital ^henyangllOOOO^hina) [Abstract】Objective： To observe the effects of sevoflurane to MAP, HR in preeclampsia patients using cesarean section till the newborn delivery.Methods： 40 parturients with severe preeclampsia,ASAII?HI,for cesarean section were equally into combine spin al-epidural an aesthesia group( C’n = 20) and sevoflura ne in halati on anesthesia group(S, n = 20). MAP and HR were monitored at the time points of before anesthesia,2,5,8,1 Omin after anesthesia and the moment of neonatus expulsion.The time from in duction to striking skin, from striking skin to n ewbor n deliver, from striking uterus to newborn deliver and the dosage of ephedrine was recorded. Apgar score of neonate was assessed. Results： The HR was decreased obviously at the time points of2,10 min .The MAP in group S was higher than that in group C at the time points of 5 min. The time from between induction and striking skin was decreased obviously .The dosage of ephedrine in group S was fewer then that in group C .Conclusion： It is an safe and effective measurement to stable maternal hemodynamics that sevoflurane inhalation anesthesia for cesarean section with severe preeclampsia to reduce the incidenee of hypotension