小剂量呋塞米在纠正妇科手术术中少尿的应用  

Low-dose of Furosemide to Correct Oliguria in Gynecological Surgery

作　　者：罗林丽[1,2] 倪娟[1,2] 罗东[1,2] 高兴蓉[1,2] 黄蔚[1,2] 林雪梅[1,2] 

机构地区：[1]四川大学华西第二医院麻醉科,成都610041 [2]四川大学华西第二医院妇女疾病与出生缺陷教育部重点实验室,成都610041

出　　处：《四川大学学报（医学版）》2013年第5期783-786,共4页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅科技支撑计划项目(No.2010GZ0293)资助

摘　　要：目的探讨小剂量呋塞米用于纠正妇科手术患者术中少尿表现的安全性和有效性。方法妇科开腹手术患者120例,随机分为3组,对照组(生理盐水5mL)、F0.5组(呋塞米0.05mg/kg)、F1组(呋塞米0.1mg/kg),每组40例。手术开始后30min记录1次总尿量,当尿量<0.5mL/(kg·h)时按照患者入组情况分别静脉注射生理盐水、呋塞米。30min后如仍为少尿状态则重复给药1次,以此类推。术中维持血容量和血压在正常范围,记录手术总时间、净补液量、术毕单位时间单位体质量的尿量、术中少尿发生率,呋塞米总用量和平均尿比重。结果 3组患者年龄、体质量、术前禁食时间、手术总时间和术中净补液量组间比较差异无统计学意义(P>0.05)。对照组单位时间单位体质量的尿量低于其他两组(P<0.01);3组术中少尿发生率分别为52.5%、12.5%和0%,对照组与其他两组相比差异有统计学意义(P<0.01);平均尿比重对照组与其他两组相比差异有统计学意义(P<0.01)。结论小剂量呋塞米用于有少尿表现的妇科手术患者,可安全、有效的维持术中正常尿量和尿比重。Objective To investigate the safety and efficay of low-dose furosemide in the correction of oliguria in the patients undergoing gynecologic surgery.Methods A total of 120 patients,aged between 20 to 50years old,who were scheduled to receive elective gynecological open surgery under general anesthesia,were randomly divided into 3 groups:the control group,furosemide 0.05mg/kg(F0.5)group and furosemide 0.1mg/kg(F1)group(n=40).During surgery,blood volume and blood pressure was maintained in the normal range.The urine volume was recorded every 30minutes.Oliguria was defined as the urine volume less than 0.5mL/(kg·h),When oliguria was observed,flurosemide or saline was given to the patients based on the enrollment status.If the patients were still oliguric 30min later,the treatment was repeated.The total time of surgery,net fluid infusion volume,urine volume per unit time per body weight at the completion of surgery,the incidence of intraoperative oliguria,the total amount of furosemide and the average specific gravity of urine were recorded.Results There was no statistically significant difference in sex,age,fasting time,the total time of surgery and intraoperative net fluid infusion volume among the three groups(P>0.05).The urine volume per unit time per body weight in control group was significantly lower than that of the other two groups(P<0.01).The incidence of intraoperative oliguria in the three groups(control,low dose,high dose groups)were 52.5%,12.5% and 0%,respectively(P<0.01).Conclusion Low-dose of furosemide could maintain normal urine volume and specific gravity of urine during gynecological surgery.

关 键 词：手术 妇科麻醉 妇科呋塞米尿量 

分 类 号：R713[医药卫生—妇产科学]