摘要
目的 :观察快速扩容预防腰 硬联合麻醉 (CSEA)下剖宫产术中循环功能的效果。方法 :选择行剖宫产手术者 12 0例 ,随机分为扩容组、麻黄碱组和对照组 ,比较 3组术前、术中与麻醉恢复期 3个时段的血压标准差及心率标准差。结果 :麻黄碱组、对照组血压标准差与扩容组比较 ,在术前、术中及麻醉恢复期均有非常显著差异 (P <0 0 1) ,对照组与麻黄碱组血压标准差比较 ,术前及麻醉恢复期差异显著 (P <0 0 5 ,P <0 0 1)。麻黄碱组、对照组心率标准差与扩容组比较 ,术前、术中差异非常显著 (P <0 0 1) ,麻醉恢复期麻黄碱组与扩容组比较 ,差异显著 (P <0 0 5 )。对照组术中平均尿量与扩容组及麻黄碱组比较 ,差异极显著 (P <0 0 1)。扩容组围麻醉期无 1例发生并发症 ,而术前麻黄碱组 15例、对照组 12例 ,麻醉恢复期 2组各有 7例发生低血压、心电图示一过性ST段压低。结论 :手术开始前快速扩容可显著降低剖宫产术CSEA期间血压及心率标准差 。
Objective:To observe the preventive effect of rapidly expanding blood volume and administration of Ephedrine on impact of combined spinal-epidural anesthesia(CSEA) on circulatory function in cesarean section.Methods:120 patients undergoing cesarean section were divided randomly into 3 groups: group of expanding blood volume(A),Ephedrine group(B) and control group(C).The differences in mean arterial pressure variability,MAPV were compared among the three groups before,during and after the operation.Results:A significant difference in MAPV was observed between Group B,C and Group A before,during and after CSEA(P<0.05);between Group B and Group C,there was a very significant difference in MAPV before and after the operation(P<0.05,P<0.01);regarding heart rate variability(HRV),Group B and Group C were very significantly different from Group A before and during the anesthesis(P<0.01)while Group B was also significantly different from Group C during postanesthetic recovery period(P<0.05).There was none of complications in Group A at stage of anesthesia whereas before the operation 15 cases of hypotension in Group B and 12 cases in Group C were encountered;during postanesthetic recovery period,hypotension happened to 7 patients in each of Group B and C with temporary low voltage in ST segment of ECG.Conclusions:Rapidly expanding blood volume before the operation could remarkably reduce the changes in MAPV and HRV during CSEA for cesaean section,benifecial to the stability of circulation system at stage of anesthesia.
出处
《临床误诊误治》
2005年第2期80-81,共2页
Clinical Misdiagnosis & Mistherapy
关键词
剖宫产术
血压测定
心率
麻醉
产科
血管容量
麻黄碱
Cesarean section
Blood presure determination
Heart rate
Anesthesia
Obstetrics
Blood volume
Ephedrine
