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麻黄碱联合6%HES共同负荷对硬膜外麻醉剖宫产胎儿脐动脉血血气的影响

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摘要 目的探讨硬膜外麻醉剖宫产手术时以麻黄碱联合6%羟乙基淀粉氯化钠溶液(HES130/0.4)共同负荷持续静脉输注对胎儿脐动脉血血气的影响。方法择期剖宫产术产妇60例,随机分为两组,每组30例,均采用硬膜外麻醉。在硬膜外注入试验剂量局麻药后,观察组(A组)以麻黄碱10mg加入6%HES130/0.4500ml快速静脉输注共同负荷,对照组(B组)单纯输注6%HES130/0.4500ml共同负荷。记录两组产妇最低SBP、最高SBP、最低HR、最高HR;记录产妇低血压、心动过缓、心动过速、恶心呕吐发生率及胎儿娩出时Apgar评分。在胎儿娩出后出现第一次呼吸前取脐动脉和脐静脉血进行血气分析。结果 A组产妇血压平稳,无低血压、心动过速、心动过缓和恶心呕吐发生,最低SBP显著高于B组(P<0.01)。B组产妇麻醉后T3、T4时点SBP与麻醉前比较显著降低(P<0.01),并显著低于A组(P<0.01);出现低血压8例(26.6%),恶心呕吐7例(23.3%)。两组均无心动过缓及心动过速发生。两组胎儿出生时Apgar评分和脐动脉血pH、PCO2、PO2及BE值差异无统计学意义(P>0.05)。结论适量麻黄碱预防性静脉持续静脉输注联合6%HES130/0.4500ml共同负荷对胎儿脐动脉血pH和BE值无影响,不会导致胎儿酸血症的发生。
机构地区 广西民族医院
出处 《海南医学》 CAS 2012年第11期6-8,共3页 Hainan Medical Journal
基金 广西壮族自治区卫生厅科研项目(编号:NO.Z2010194)
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