摘要
目的探讨子痫前期患者剖宫产术后联用右美托咪啶降血压的疗效。方法本研究为1∶1的病例对照研究。病例来源于南华大学附属第一医院与南华大学附属第二医院。按照剖宫产术后24h血压控制情况,分为血压达标组与血压未达标组。均匀匹配两组患者的年龄、体重、基础血压,采用多元logistic回归分析患者术后降压治疗效果的影响因素。结果两组患者心率、Snaith临床焦虑评分、血肌酐、谷丙转氨酶、总胆固醇、甘油三酯、孕产次、血清钠离子浓度、血清钙离子浓度、血糖、24h蛋白尿相关指标差异均无统计学意义(P>0.05),血压未达标组硝苯地平用药剂量高于血压达标组(P=0.001),血压达标组右美托咪啶用药剂量高于血压未达标组,差异具有统计学意义(P=0.000)。其余治疗用药剂量两组均无统计学差异(P>0.05)。多因素logistic回归分析显示右美托咪啶是子痫前期患者术后血压的独立保护因素(P=0.004)。两组患者治疗期间不良反应发生率无统计学差异(P>0.05)。结论子痫前期患者剖宫产术后联用小剂量右美托咪啶,可避免患者术后高血压的发生,为子痫前期患者术后降压治疗提供了新的治疗思路。
Objective To investigate the effect of dexmedetomidine on lowering blood pressure in patients with preeclampsia after cesarean section.Methods This study was a 1∶1 case-control study.The cases were obtained from the First Affiliated Hospital of University of South China and the Second Affiliated Hospital of University of South China.According to whether the blood pressure was controlled in the normal range 24 hours after cesarean delivery,they were divided into the group with blood pressure attainment and the group with blood pressure non-attainment.The age,weight,and basal blood pressure of patients in both groups were matched equally,and the factors influencing the effect of postoperative antihypertensive treatment in patients were analyzed by multivariate logistic regression.Results Heart rate,Snaith clinical anxiety score,serum creatinine,alanine aminotransferase,total cholesterol,triglyceride,maternal time,concentration of serum sodium,serum calcium ion concentration,blood sugar,24-hour proteinuria related index difference of two groups of patients had no statistical significance(P>0.05).The dosage of nifedipine in the case group was higher than that in the control group(P=0.001),and the dosage of dexmedetomidine in the control group was higher than that in the case group,the difference being statistically significant(P=0.000).Multivariate logistic regression analysis showed that dexmedetomidine was an independent protective factor for postoperative hypertension in patients with preeclampsia(P=0.004).There was no statistical difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusions The combination of low-dose dexmedetomidine after cesarean section in patients with preeclampsia is a protective factor for hypertension in patients with preeclampsia,which provides a new treatment idea for postoperative antihypertensive treatment in patients with preeclampsia.
作者
杨烨玮
曹梦悦
吴鹏
杨春芬
桂培根
Yang Yewei;Cao Mengyue;Wu Peng;Yang Chunfen;Gui Peigen(Institute of pathogenic biology,University of South China;School of public health,Universityof South China;Department of critical medicine,Yueyang maternal and child health hospita;Department of critical medicine,Hengyang maternal and child health hospital;The First Affiliated Hospital of University of South China;Emergency and critical medical center,Changshafourth hospital)
基金
湖南省自然科学基金(项目编号:2018JJ6118)
关键词
子痫前期
右美托咪啶
交感应激
血压
Dexmedetomidine
Preeclampsia
Sympathetic stress
Blood pressure
