發(fā)布時間：2018-04-17 06:26

  本文選題：剖宮產(chǎn)術(shù) + 腰-硬聯(lián)合阻滯�。� 參考：《上海交通大學(xué)學(xué)報(醫(yī)學(xué)版)》2017年08期

【摘要】：目的·評價對于脊椎麻醉后低血壓高危產(chǎn)婦預(yù)防性使用去氧腎上腺素的效果和安全性。方法·選擇麻醉前仰臥位與右側(cè)臥位平均動脈壓(MAP)差值大于8mmHg(1mmHg=0.133kPa)行擇期剖宮產(chǎn)術(shù)的產(chǎn)婦50例,隨機分為高危預(yù)防組(A組)和高危對照組(B組),再選取MAP差值小于8mmHg的產(chǎn)婦25例為低危預(yù)防組(C組)。脊椎麻醉完成后,A組和C組立即靜脈注射去氧腎上腺素50μg后,給予50μg/min泵注,10min后改為25μg/min直至胎兒取出;B組給予同等容量和泵注速度的生理鹽水。比較3組產(chǎn)婦麻醉后低血壓、反應(yīng)性高血壓、惡心嘔吐、心動過緩發(fā)生率,新生兒出生后1min和5min的Apgar評分。結(jié)果·3組產(chǎn)婦脊椎麻醉后低血壓發(fā)生率分別為28%、76%和16%,A組、C組顯著低于B組(均P0.01)。A組與C組反應(yīng)性高血壓發(fā)生率分別為4%和28%,差異有統(tǒng)計學(xué)意義(P=0.015)。新生兒出生后1min和5min的Apgar評分組間比較,差異均無統(tǒng)計學(xué)意義(均P0.05)。結(jié)論·針對脊椎麻醉后低血壓高危產(chǎn)婦預(yù)防性使用去氧腎上腺素能明顯降低脊椎麻醉后低血壓的發(fā)生,且無明顯不良反應(yīng),對新生兒Apgar評分無影響。
[Abstract]:Objective to evaluate the efficacy and safety of prophylactic use of noradrenaline in high risk women with hypotension after spinal anesthesia.Methods 50 parturients undergoing elective cesarean section were selected for elective cesarean section in supine position and right lateral position.They were randomly divided into high risk prevention group (group A) and high risk control group (group B). 25 cases of parturient whose MAP difference value was less than 8mmHg were selected as low risk prevention group (group C).After spinal anesthesia was completed, 50 渭 g of noradrenaline was injected intravenously in group A and group C, then injected with 50 渭 g/min pump for 10 minutes and then changed to 25 渭 g/min until fetuses were taken out of group B to receive saline of the same volume and velocity.The incidence of hypotension, reactive hypertension, nausea and vomiting, bradycardia, postnatal 1min and 5min were compared among the 3 groups.Results the incidence of hypotension in group A was significantly lower than that in group B (P 0.01). The incidence of reactive hypertension was 4% in group A and 28% in group C, respectively. The difference was statistically significant.There was no significant difference in the Apgar scores of 1min and 5min between the newborns after birth (P 0.05).Conclusion prophylactic use of norepinephrine in high risk women with hypotension after spinal anesthesia can significantly reduce the incidence of hypotension after spinal anesthesia and has no significant adverse effects on neonatal Apgar score.
【作者單位】： 上海中冶醫(yī)院麻醉科;
【分類號】：R614

【相似文獻】

相關(guān)期刊論文 前10條

1 李德馨;秦搤彥;沈嘉保;李明尀;;脊椎麻醉629例分析[J];人民軍醫(yī);1957年10期

2 宋曉峰;靳冰;;脊椎麻醉并發(fā)癥的預(yù)防和治療[J];人民軍醫(yī);1966年02期

3 黃霈;;脊椎麻醉后頭痛的原因和預(yù)防[J];中級醫(yī)刊;1957年04期

4 王大柱;陳衍，

本文編號：1762443