益极疏对脊麻-硬膜外联合麻醉低血压的防治作用  

Comparison of ployglucose and sodium chloride injection effect to hypotension of inferior abdominal and pelvic combined spinal-epidural anesthesia surgerical patients

作　　者：刘定一 曾海华 

机构地区：[1]长沙市第三医院麻醉科,湖南长沙410015

出　　处：《中国现代医学杂志》2007年第5期618-619,622,共3页China Journal of Modern Medicine

摘　　要：目的观察益极疏防治脊麻-硬膜外联合麻醉下腹盆部手术(剖腹产除外)病人低血压的效果。方法将200例行择期或急诊腹盆部手术病人随机分成两组。麻醉前先输入缩合葡萄糖(益极疏TM)组(Ⅰ组)及先输入林格氏液组(Ⅱ组)。病人行麻醉前30min快速输入上述两种液体,输入300mL时开始操作,输完500mL时,麻药注入完毕。腰麻后20min内,不同时间记录病人的心率和血压,血压低于基础值的70%或平均动脉压<8kpa为低血压,心率<50次/min为心率减慢。最后以组间血压下降的病例百分比和使用升压药人次及同组血压下降值进行比较。结果益极疏TM组(Ⅰ组)有10例,林格氏液组(Ⅱ组)有44例血压下降,而使用升压药,两者比较差异有显著性,益极疏TM组(Ⅰ组)预防低血压的作用明显好于林格氏液组(Ⅱ组)。结论缩合葡萄糖氯比钠注射液(益极疏TM)对脊麻-硬膜外联合麻醉下腹盆部手术有很好的治疗作用。[Objective] To observe different fluid＇s effects to defend hypotension of the inferior abdominal and pelvic combined spinal-epidural anesthesia surgerical patients. [Methods] To divide two hundred abdominal and pelvic surgical patients （pick date or acute disease） into two groups at random. Before anesthesia, transfuse ployglucose （group Ⅰ） and sodium chloride injection, or Ringer＇s （group Ⅱ） at first. Quickly transfuse the above two groups of fluid in thirty minutes before anesthesia, then start to operate when 300 mL has been transfused and all anesthetic should be injected in when 500 mL has been transfused. Under spinal block, record patient＇s heart rate and blood pressure at different periods within twenty minutes. Blood pressure 70% lower than the basic record or mean arterial pressure lower than 8 kpa was considered to be hypotension and heart rate less than fifty times per minute was considered to be heart rate reduced. Finally, make comparison of the percentage of blood pressure reduced cases between the groups, the number of ephedrine and the records of blood pressure reduce in each group. [ Results]During blood pressure reduced cases, there were ten cases in group Ⅰ and forty-four cases in group Ⅱ .Yet, the effect of the ephedrine to group was obviously different. The effect of group Ⅰ to defend hypotension was certainly much more better than group Ⅱ. [Conclusion] Ployglucose and sodium chloride injection＇s effect to defend hypotension of the inferior abdominal and pelvic combined spinal-epidural anesthesia surgery in capacity therapy are very good, but Ployglucose is better than Ringer＇s.

关 键 词：缩合葡萄糖氯化钠注射液 脊麻-硬膜外联合麻醉 低血压 

分 类 号：R614.42[医药卫生—麻醉学]