三种溶液预防老年患者TURP术腰麻后低血压的临床实验  

Infusion three pre-loading solution to prevent hypotension in elderly patients undergoing combined spinal anesthesia for TURP

作　　者：林洁[1] 魏新川[1] 李运富[1] 罗贞[1] 文春玉[1] 

机构地区：[1]四川大学华西医院麻醉科,四川成都610041

出　　处：《四川医学》2010年第1期28-29,共2页Sichuan Medical Journal

摘　　要：目的对腰硬联合麻醉下行经尿道前列腺电切术(TURP)老年患者,预输注负荷量4%琥珀酰明胶(佳乐施)、6%羟乙基淀粉130/0.4(万汶)和复方乳酸钠液,比较其减轻腰麻后低血压的效果。方法120例ASA I^II级患者,随机分为佳乐施组(G组)、万汶组(V组)和复方乳酸钠组(L组),每组40例,在腰麻注药前,按8~10m l/kg输入各组液体;测量基础及麻醉后30m in内生命体征值,观察术中恶心、呕吐、术后头痛等不良反应。结果麻醉后30m in内最低收缩压(SBP):G组、V组与L组比较差异均有统计学意义(P<0.05),G组和V组间差异无统计学意义(P>0.05)。各组均无不良反应发生。结论佳乐施和方汶均可有效预防TURP术患者腰麻后低血压发生,但佳乐施在血液存留时间较短,不会进一步加重该手术所特有的循环超负荷现象。Objective To compare three pre-loading solution of 4% succinylated gelatin injection （Gelofusine）, 6% hydroxyethyl starch 130/0. 4（Voluven） and compound sodium lactate Ringer in preventing hypotension in elderly patients undergoing combined spinal and epidural anesthesia（CSEA） for TURP. Melhods 120 elder patients, ASA Ⅰ～Ⅱ, were randomly divied into gelofusine （G） group （ n = 4-0 ） , voluven （ V ） group （ n = 40 ） and compound sodium lactate ringer （L） group （ n = 40 ）. The solution was given at 8 - 10ml/kg in each group before the CSEA drug was administrated. BP,HR,and SPO2 were recorded before the procedure of spinal anesthesia and within 30 minutes after the spinal anesthesia, perioperative nausea and vomitting, postoperative headache were observed. Results The minimum systolic blood pressure（SBP） in L group was significant lower than that in G and V group, there was no difference between G and V group. No adverse events had been observed in all groups. Conclusion Both gelofusine and voluven can effectively prevent the hypotension in elderly patients undergoing CSEA for TURP,when refering to the time stayed in the vascular and the price,gelofusine is better than voluven.

关 键 词：琥珀酰明胶 羟乙基淀粉 复方乳酸钠液 腰硬联合麻醉 低血压 

分 类 号：R614[医药卫生—麻醉学]