本文選題：剖宮產(chǎn) + 蛛網(wǎng)膜下腔阻滯麻醉��； 參考：《廣西醫(yī)學(xué)》2016年10期

【摘要】：目的探討蛛網(wǎng)膜下腔阻滯麻醉(腰麻)剖宮產(chǎn)術(shù)中應(yīng)用麻黃堿復(fù)合去氧腎上腺素對(duì)產(chǎn)婦血流動(dòng)力學(xué)及新生兒動(dòng)脈血?dú)夥治龅挠绊憽７椒ㄟx擇腰麻下剖宮產(chǎn)產(chǎn)婦90例,按隨機(jī)數(shù)字表法分為3組,每組30例。腰麻成功后A組靜脈注射麻黃堿6 mg、B組靜脈注射去氧腎上腺素60μg、C組靜脈注射麻黃堿3 mg復(fù)合去氧腎上腺素30μg。記錄入手術(shù)室時(shí)(T0)、腰麻注藥后2 min(T1)及5 min(T2)、胎兒娩出時(shí)(T3)、手術(shù)結(jié)束時(shí)(T4)3組產(chǎn)婦的收縮壓(SBP)、舒張壓(DBP)及心率(HR),比較3組產(chǎn)婦不良反應(yīng)發(fā)生情況以及新生兒臍動(dòng)脈血血?dú)夥治觥⑸? min Apgar評(píng)分。結(jié)果 3組的SBP、DBP、HR比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),其中在T2至T4,C組SBP及HR水平介于A組及B組之間;各組的SBP、DBP、HR均有隨時(shí)間變化的趨勢(shì)(P0.05),腰麻后(T1)A組及B組產(chǎn)婦SBP及DBP較T0明顯下降,而C組較T0增高。C組產(chǎn)婦惡心、嘔吐發(fā)生率低于A、B組(P0.05)。B、C組新生兒的p H和剩余堿高于A組(P0.05),而C組的剩余堿高于B組(P0.05);C組的Pa CO2和乳酸水平均低于A組(P0.05),且C組的Pa O2高于A組及B組(P0.05);3組的新生兒5 min Apgar評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論腰麻下剖宮產(chǎn)術(shù)中,在穩(wěn)定產(chǎn)婦血流動(dòng)力、預(yù)防低血壓、降低不良反應(yīng)發(fā)生率以及減輕新生兒的酸中毒方面,麻黃堿復(fù)合去氧腎上腺素優(yōu)于單用去氧腎上腺素或麻黃堿。
[Abstract]:Objective to investigate the effects of ephedrine combined with norepinephrine on maternal hemodynamics and arterial blood gas analysis during cesarean section under subarachnoid block anesthesia.Methods 90 cases of cesarean section under spinal anesthesia were randomly divided into 3 groups, 30 cases in each group.After spinal anesthesia, ephedrine was injected intravenously in group A (6 mg) and ephedrine was injected intravenously in group B (60 渭 g / g). Group C was treated with ephedrine (3 mg) and noradrenaline (30 渭 g).The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HRV) were recorded at the end of operation room, 2 min after injection of spinal anaesthesia (T1) and 5 min after injection of drugs. The blood gas of umbilical artery blood gas of newborns was analyzed.Postnatal 5 min Apgar score.But group C was higher than T0. Group C had nausea,Comparison of 5 min Apgar scores of children,The difference was not statistically significant (P 0.05).Conclusion during cesarean section under spinal anesthesia, ephedrine combined with norepinephrine is superior to noradrenaline or ephedrine in stabilizing the blood flow, preventing hypotension, reducing the incidence of adverse reactions and alleviating the acidosis of newborn.
【作者單位】： 中南大學(xué)湘雅醫(yī)學(xué)院附屬海口醫(yī)院暨�？谑腥嗣襻t(yī)院麻醉科;
【分類號(hào)】：R614.4

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