摘要
目的探讨胶体液与晶体液预扩容对腰硬联合麻醉下剖宫产患者血流动力学的影响。方法便利选取于该院2015年10月—2016年5月择期行剖宫产足月妊娠孕妇120例,ASAI-II级,随机平均分为3组。入室后常规记录基础循环参数。麻醉前A组给予羟乙基淀粉130/0.4氯化钠注射液;B组钠钾钙镁葡萄糖注射液;C组乳酸钠林格液各500 m L扩容,然后行腰硬联合麻醉。观察3组产妇麻醉前、后;胎儿出生后;手术结束即时生命体征的变化及不良反应发生率。结果手术均顺利完成,A组围术期血压T2(121.0±13.9)mm Hg、T5(118.0±12.7)mm Hg变化的幅度小于B组T2(122.0±12.5)mm Hg、T5(110.0±11.4)mm Hg、C组T2(120.0±14.7)mm Hg、T5(109.0±12.2)mm Hg(P<0.05);A组术中血管活性药物使用(6例)及恶心呕吐发生率(6例)明显小于B组(14例、12例)、C组(18例、14例)(P<0.05)。结论腰硬联合麻醉前预输注羟乙基淀粉能有效减轻剖宫产手术中低血压的程度。
Objective To observe th e effect of Different F lu id E x p an sion on th e hemodynamics of p a t ien ts with u te r in e - in -cision delivery under the combined spinal and epidural anes thesia. Methods 120 c a se s of fu l l - te rm p reg n an t d elive ry wom-en with convenient select ive uterine-incision delivery from October 2015 to May 2016 were selected and divided into three groups, the basic loop parameter were routinely recorded af ter admission, and before the anaesthesia, the group A were giv-en the hydroxyethyl s tarch130/0.4 sodium chlor ide inject ion, while the group B were given the potas sium magnesium calci -um and glucose inject ion, and the group C were given the lactated ringer’s solution 500 mL expansion, and then the com-bined spinal and epidural anesthesia wad conducted, and the changes of vital signs and incidence rate of adverse reactions of the three groups before and af ter anes thesia, af ter the birth of fetuses, and at the end of operat ion. Results After th e su c -cess ful complet ion of operat ion, the blood hyper tension T2 and T5 change ranges dur ing the per ioperat ive period and in the group A were less than those in the group B and in the group C, [（121.0±13.9）mmHg, （118.0±12.7）mmHg vs （122.0±12.5） mmHg, （110±11.4）mmHg vs （120.0±14.7）mmHg, （109.0±12.2）mmHg] （P〈0.05）, and the intraoperative blood vessel active drug use case and case with nausea and vomiting were respectively 6 cases in the group A, which were obviously lower than those in the group B and the group C（14 cases and 12 cases） and （18 cases and 14 cases）（P〈0.05）. Conclusion The p r e -transfus ion of hetastarch before the combined spinal and epidural anesthesia can effectively relieve the low blood hyper ten-sion degree in the cesarean operation.
出处
《中外医疗》
2017年第3期45-46,50,共3页
China & Foreign Medical Treatment
关键词
胶体液
预扩容
剖宫产
血流动力学
腰硬联合麻醉
Colloid solution
P re -e x p a n s io n
Ute rin e - in c is io n d elivery
Hemodynamics
Combined sp in a l an d ep id u ra l anes thesiaq
