摘要
目的：探讨小剂量甲氧明维持剖宫产手术中循环稳定的作用，以寻找甲氧明预防和治疗剖宫产术中低血压的最佳方案。方法：择期剖宫产产妇200例随机分为试验组和对照组（每组100例），实验组于L3-4腰-硬联合穿刺，注入麻醉药。麻醉完成后即刻开始输注甲氧明；对照组穿刺注入麻醉药后即刻不给予甲氧明，当产妇出现血压下降幅度超过15％时给予静注甲氧明2～3mg，预先稀释至20ml。比较两组产妇腰麻前（T0）、腰麻后5min（T1）、腰麻后10min（T2）、腰麻后15min（T3）、手术结束（T4）五个时间点的收缩压（SBP）、舒张压（DBP）、心率（HR）变化情况。记录两组产妇新生儿的脐动脉血气分析结果及1minApgar评分情况。比较两组产妇术中药品不良反应发生情况。结果：两组T1～T3时的SBP、DBP均明显低于Tn时（P〈0．05）；对照组SBP、DBP较试验组下降更明显（P〈0．05）。对照组T1～T4时的HR均明显低于T0时；而试验组T1～T4时的HR较T0时差异无统计学意义（P〉0．05）。对照组T1～T3时的HR值明显低于试验组（P〈0．05）。两组新生儿pH、PCO2、PO2、Apgar评分比较，差异均无统计学意义（P〉0．05）。试验组产妇术中不良反应发生率明显低于对照组（P〈0．05）。结论：应用微量泵预防性使用甲氧明维持剖宫产术中的循环稳定性较为可靠，且对新生儿无不良影响。
Objective： To investigate the cycling stability effect of methoxamine at low dose in cesarean section in order to find the optimal regimen for the prevention and treatment of hypotension during cesarean section. Methods： Totally 200 patients with scheduled cesarean section were selected and randomly divided into the experimental group and the control group with 100 ones in each. The experimental group was anesthetized through L3-4 lumbar-peridural puncture immediately followed by the infusion of methoxamine, and the control group was anesthetized in the same way, and only when the blood pressure was dropped by more than 15%, the infusion of methoxamine was given immediately （2-3mg diluted to 20ml）. The systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） were compared between the two groups at five time points of before spinal anesthesia （T0 ）, 5 min after spinal anesthesia （T1）, 10 min after spinal anesthesia （T2 ）, 15 min after spinal anesthesia （T3 ） and the end of the operation （T4）. The umbilical arterial blood gas and the 1-minute Apgar score of the newborn were recorded, and the adverse reactions in the two groups were com- pared. Results： In T1 -T3 , SBP and DBP in the two groups were significantly lower than those at To （P 〈 0.05）, and the decrease in the experimental group was more significant than that in the control group （P 〈 0.05）. In T1 -T4, HR in the control group was significantly lower than that in To, while HR in the experimental group had no significant difference when compared with that in To （ P 〉 0.05 ） , and HR in the control group was significantly lower than that in the experimental group in T1 -T3 （ P 〈 0.05 ）. There were no significant differences in the scores of pH, PO2, PCO2 and Apgar of the newborn between the two groups （ P 〉 0.05 ）. The incidence of adverse reactions in the experimental group was significantly lower than that in the control group （P 〈 0.05 ）. Conclusion： The
出处
《中国药师》
CAS
2016年第2期298-300,共3页
China Pharmacist
关键词
甲氧明
剖宫产术
腰-硬联合麻醉
Methoxamine
Cesarean section
Combined lumbar-peridural anesthesia
