预输贺斯对剖宫产腰-硬联合麻醉血压的影响及护理  

作　　者：朱琳[1] 彭顺秀[1] 郑洁[1] 徐善玉[1] 

机构地区：[1]南方医科大学附属宝安医院手术室,广东深圳518101

出　　处：《现代临床护理》2006年第1期4-6,共3页Modern Clinical Nursing

摘　　要：目的观察预输贺斯(HES)对剖宫产腰-硬联合麻醉血压的影响及总结护理措施。方法将120例剖宫产手术产妇随机分为HES组、复方乳酸钠(LR)组、对照组3组,腰-硬联合麻醉用药前HES组输入6％HES 500 ml,LR组输入复方乳酸钠1 000 ml,均在30 min内输完,对照组开放静脉后即刻麻醉,记录并分析3组同期收缩压(SBP)的变化。结果①3组产妇注药后SBP出现下降趋势,3-5 min下降到最低,最低SBP均明显低于基础值,与基础值两两比较,均 P<0．01,差异有统计学意义;HES组最低SBP明显高于LR组和对照组,低血压发生率(10．0％)明显低于LR组(27．5％) 和对照组(30．0％),HES组与其他两组比较,均P<0．05,差异有统计学意义,而LR组、对照组间无显著性差异(P> 0．05)。②HES组、LR组、对照组分别有4例、11例、12例出现低血压,各有2例、8例、8例患者用麻黄碱得到纠正,其余病例经快速补液和调整体位后得以恢复。结论预输HES可预防和减少剖宫产腰-硬联合麻醉低血压的发生率。Objective To study the effect of hydroxyethylstarch （HES） on blood pressure under combined lumberextradural anaesthesia and propose relative nursing strategies during cesarean operation. Methods 120 patients with cesarean operation were divided into HES group （40cases）, LR group （40cases） and control group （40cases）. Before lumber-extradural anaesthesia, 500ml 6%HES solution was infused within 30min in HES group and 1000ml lactated Ringer＇s solution was given in LR group. At the same time, the stress blood pressure （SBP） were examined and analyzed. Results ①SBP of three groups showed a decreased trend after injection of anaesthetic, the SBP was the lowest in 3 -5 min. The lowest SBP of three groups were lower than their basic SBP （P 〈 0.01）. The lowest SBP of HES groups was higher than LR and control group （P 〈 0.01）. The incidence of hypotension （10.0%） was lower than LR （27.5%） and control groups （30.0%） （P 〈 0.05）. But there were no significant difference between LR and control groups.②The hypotension occurred in 4, 11 and 12 cases in HES, LR and control groups, respectively. The hypotension of 2, 8 and 8 cases in HES, LR and control groups was recovered after injection of ephedrine, respectively. Other cases were recovered after adjustment of infusion rate and body position. Conclusion HES solution before transfusion could prevent and reduce the rate of blood pressure under combined lumber-extradural anaesthesia during cesarean operation

关 键 词：剖宫产术 麻醉 血压 贺斯 护理 

分 类 号：R473.71[医药卫生—护理学]