目的:探讨复方丹参注射液对重度子痫前期患者的治疗效果、凝血功能及妊娠结局的影响。方法:选取2016年1月-2017年5月在某院治疗的重度子痫前期患者100例,随机分为对照组和观察组。对照组给予低分子肝素钙治疗,观察组在对照组的基础上给...目的:探讨复方丹参注射液对重度子痫前期患者的治疗效果、凝血功能及妊娠结局的影响。方法:选取2016年1月-2017年5月在某院治疗的重度子痫前期患者100例,随机分为对照组和观察组。对照组给予低分子肝素钙治疗,观察组在对照组的基础上给予复方丹参注射液,之后对2组患者的治疗效果、凝血功能及妊娠结局进行评估。结果:治疗后2组患者平均动脉压(MAP)、24 h尿蛋白(24 h UP)、尿氮素(BUN)及谷丙转氨酶(ALT)水平均较治疗前显著降低,24 h尿量较治疗前显著升高,观察组患者治疗后MAP、24 h UP、BUN及ALT水平分别为(90.93±2.97)mmHg、(341.58±27.64)g·d-1、(3.45±0.11)mmol·L^(-1)及(19.64±1.46)U·L^(-1),显著低于对照组治疗后,24 h尿量为(2 324.11±189.82)mL,显著高于对照组治疗后,差异有统计学意义(P<0.05);治疗后,2组患者凝血酶原时间(PT)及部分凝血活酶时间(APTT)水平均显著升高,D-二聚体(D-D)及纤维蛋白原(Fg)水平均显著降低,观察组治疗后PT及APTT水平分别为(13.67±0.38)s及(35.23±0.95)s,显著高于对照组治疗后,D-D及Fg水平分别为(1.28±0.04)mg·L^(-1)及(2.31±0.18)g·L^(-1),显著低于对照组治疗后,差异有统计学意义(P<0.05);与对照组相比,观察组患者分娩孕周、阴道分娩率及新生儿体质量均显著大于对照组,产后24 h出血量及并发症发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论:复方丹参注射液能对重度子痫前期患者产生有效的治疗效果,改善患者凝血功能及妊娠结局,疗效显著,值得临床进一步推广使用。展开更多
Background： Spinal anesthesia was considered as a reasonable anesthetic option in severe preeclampsia when cesarean delivery is indicated, and there is no indwelling epidural catheter or contraindication to spinal an...Background： Spinal anesthesia was considered as a reasonable anesthetic option in severe preeclampsia when cesarean delivery is indicated, and there is no indwelling epidural catheter or contraindication to spinal anesthesia. However, the ideal dose of intrathecal bupivacaine has not been quantified for cesarean delivery for severe preeclamptic patients. This study aimed to determine the ED50 and ED95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery. Methods： Two hundred severely preeclamptic patients are undergoing elective cesarean delivery under combined spinal-epidural anesthesia enrolled in this randomized, double-blinded, dose-ranging study. Patients received 4 rag, 6 mg, 8 mg, or 10 mg intrathecal hyperbaric bupivacaine with 2.5 μg sufentanil. Successful spinal anesthesia was defined as a T6 sensory level achieved within 10 minutes after intrathecal drug administration and/or no epidural supplement was required during the cesarean section. The ED50 and ED95 were calculated with a logistic regression model. Results： ED90 and ED95 ofintrathecal bupivacaine for successful spinal anesthesia were 5.67 mg （95% confidence interval [C/]： 5.20-6.10 mg） and 8.82 mg （95% CI： 8.14-9.87 mg） respectively. The incidence of hypotension in Group 8 mg and Group 10 mg was higher than that in Group 4 mg and Group 6 mg （P 〈 0.05）. The sensory block was significantly different among groups 10 minutes after intrathecal injection （P 〈 0.05）. The use of lidocaine in Group 4 mg was higher than that in other groups （P 〈 0.05）. The use of phenylephrine in Group 8 mg and Group 10 mg was higher than that in the other two groups （P 〈 0.05）. The lowest systolic blood pressure before the infant delivery of Group 8 mg and Group 10 mg was lower than the other two groups （P 〈 0.05）. The satisfaction of muscle relaxation in Group 4 mg was lower than other groups （P 〈 0.05）. There was no significant difference in patients＇ satisfaction a展开更多
文摘目的:探讨复方丹参注射液对重度子痫前期患者的治疗效果、凝血功能及妊娠结局的影响。方法:选取2016年1月-2017年5月在某院治疗的重度子痫前期患者100例,随机分为对照组和观察组。对照组给予低分子肝素钙治疗,观察组在对照组的基础上给予复方丹参注射液,之后对2组患者的治疗效果、凝血功能及妊娠结局进行评估。结果:治疗后2组患者平均动脉压(MAP)、24 h尿蛋白(24 h UP)、尿氮素(BUN)及谷丙转氨酶(ALT)水平均较治疗前显著降低,24 h尿量较治疗前显著升高,观察组患者治疗后MAP、24 h UP、BUN及ALT水平分别为(90.93±2.97)mmHg、(341.58±27.64)g·d-1、(3.45±0.11)mmol·L^(-1)及(19.64±1.46)U·L^(-1),显著低于对照组治疗后,24 h尿量为(2 324.11±189.82)mL,显著高于对照组治疗后,差异有统计学意义(P<0.05);治疗后,2组患者凝血酶原时间(PT)及部分凝血活酶时间(APTT)水平均显著升高,D-二聚体(D-D)及纤维蛋白原(Fg)水平均显著降低,观察组治疗后PT及APTT水平分别为(13.67±0.38)s及(35.23±0.95)s,显著高于对照组治疗后,D-D及Fg水平分别为(1.28±0.04)mg·L^(-1)及(2.31±0.18)g·L^(-1),显著低于对照组治疗后,差异有统计学意义(P<0.05);与对照组相比,观察组患者分娩孕周、阴道分娩率及新生儿体质量均显著大于对照组,产后24 h出血量及并发症发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论:复方丹参注射液能对重度子痫前期患者产生有效的治疗效果,改善患者凝血功能及妊娠结局,疗效显著,值得临床进一步推广使用。
基金This study was supported partly by the fund from National Natural Science Foundation of China （NSFC, No. 81271237 and No. 81471126） and the fund from Jiaxing Science and Technol- ogy Bureau in Zhejiang Province, China （No. 2013AY21050-2）.ACKNOWLEDGMENTS The authors would like to thank all staffs in the Department of Anesthesia and Operating Room of Jiaxing Maternity and Child Care Hospital for their help in this study.
文摘Background： Spinal anesthesia was considered as a reasonable anesthetic option in severe preeclampsia when cesarean delivery is indicated, and there is no indwelling epidural catheter or contraindication to spinal anesthesia. However, the ideal dose of intrathecal bupivacaine has not been quantified for cesarean delivery for severe preeclamptic patients. This study aimed to determine the ED50 and ED95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery. Methods： Two hundred severely preeclamptic patients are undergoing elective cesarean delivery under combined spinal-epidural anesthesia enrolled in this randomized, double-blinded, dose-ranging study. Patients received 4 rag, 6 mg, 8 mg, or 10 mg intrathecal hyperbaric bupivacaine with 2.5 μg sufentanil. Successful spinal anesthesia was defined as a T6 sensory level achieved within 10 minutes after intrathecal drug administration and/or no epidural supplement was required during the cesarean section. The ED50 and ED95 were calculated with a logistic regression model. Results： ED90 and ED95 ofintrathecal bupivacaine for successful spinal anesthesia were 5.67 mg （95% confidence interval [C/]： 5.20-6.10 mg） and 8.82 mg （95% CI： 8.14-9.87 mg） respectively. The incidence of hypotension in Group 8 mg and Group 10 mg was higher than that in Group 4 mg and Group 6 mg （P 〈 0.05）. The sensory block was significantly different among groups 10 minutes after intrathecal injection （P 〈 0.05）. The use of lidocaine in Group 4 mg was higher than that in other groups （P 〈 0.05）. The use of phenylephrine in Group 8 mg and Group 10 mg was higher than that in the other two groups （P 〈 0.05）. The lowest systolic blood pressure before the infant delivery of Group 8 mg and Group 10 mg was lower than the other two groups （P 〈 0.05）. The satisfaction of muscle relaxation in Group 4 mg was lower than other groups （P 〈 0.05）. There was no significant difference in patients＇ satisfaction a
