应用高渗氯化钠羟乙基淀粉40注射液预防剖宫产术低血压多中心临床研究  

Multi-center clinical study on assessing the effects of preinjecting hypertonic sodium chloride hydroxylethyl starch 40 on preventing hypotension during caesarean section

作　　者：孟凡民[1] 张加强[1] 张卫[2] 姜丽华[3] 董铁立[4] 马传根[5] 吴建厂[6] 李宪营[7] 娄彦[8] 盛莉[9] 孟庆友 

机构地区：[1]河南省人民医院麻醉科,郑州市450003 [2]郑州大学第一附属医院麻醉科 [3]郑州大学第三附属医院麻醉科 [4]郑州大学第二附属医院麻醉科 [5]河南大学附属淮河医院麻醉科 [6]周口市中心医院麻醉科 [7]漯河市中心医院麻醉科 [8]洛阳市中心医院麻醉科 [9]解放军第159医院麻醉科 [10]解放军第152医院麻醉科

出　　处：《中华实用诊断与治疗杂志》2010年第7期635-637,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：吴孟超医学科技基金会容量治疗专项基金资助项目(C2006023)

摘　　要：目的：观察高渗氯化钠羟乙基淀粉40注射液对腰-硬联合麻醉下剖宫产手术产妇低血压的防治效果。方法：选择来自10个研究中心需在腰-硬联合麻醉下行剖宫产手术的产妇220例,随机分为2组,麻醉前Ⅰ组静脉滴注高渗氯化钠羟乙基淀粉40注射液5 mL/kg;Ⅱ组静脉滴注羟乙基淀粉130/0.4氯化钠注射液5 mL/kg。观察输注前（T0）、输注完毕后即刻（T1）、穿刺完毕平卧后即刻（T2）、平卧后1 min（T3）、2 min（T4）、3 min（T5）、4 min（T6）、5 min（T7）收缩压、舒张压、平均动脉压及心率。记录术中输液总量、术中尿量、出血量、手术时间、低血压发生率及麻黄碱使用率。结果：2组产妇平卧后T3~7收缩压、舒张压及平均动脉压与T0比较差异均有统计学意义（P〈0.05）。Ⅰ组产妇平卧后各时间点的收缩压、舒张压及平均动脉压与Ⅱ组比较差异有统计学意义（P〈0.05）。Ⅰ组低血压发生率显著低于Ⅱ组,差异有统计学意义（P〈0.01）。麻黄素使用率、术中尿量及术后24 h尿量2组比较差异有统计学意义（P〈0.01）。结论：麻醉前静脉滴注高渗氯化钠羟乙基淀粉40注射液可预防腰-硬联合麻醉下剖宫产术的低血压。Objective To investigate the effects of preinjecting hypertonic sodium chloride hydroxyethyl starch 40 on preventing hypotension during spinal-epidural anaesthesia for caesarean section.Methods A total of 220 pregnant women undergoing caesarean section were randomly divided into two groups.Hypertonic sodium chloride hydroxyethyl starch 40 5 mL/kg（groupⅠ） and hydroxyethyl starch 5 mL/kg（groupⅡ） were infused before the combined spinal-epidural anesthesia.The systolic blood pressure,diastolic blood pressure,mean arterial pressure,and heart rate were recorded before infusion（T0）,at the end of infusion（T1）,immediately after supine position（T2）,1 minute（T3）,2 minutes（T4）,3 minutes（T5）,4 minutes（T6）,5 minutes（T7） after supine position.The total infusion volume,urine volume,bleeding volume,operation time,incidence of hypotension and usage of ephedrine were recorded.Results The systolic blood pressure,diastolic blood pressure,mean arterial pressure of T3,T4,T5,T6 and T7 were significantly different from those of T0 in the two groups（P0.05）.The systolic blood pressure,diastolic blood pressure and mean arterial pressure were lower at T3,T4,T5,T6 and T7 in groupⅡ than those in groupⅠ（P0.05）.The incidence of hypotension was significantly lower in group Ⅰ than that in group Ⅱ（P0.01）.There were statistic differences in the usage of ephedrine,urinary volume of intraoperation and 24 hours after operation between two groups（P0.01）.Conclusion Preinjecting hypertonic sodium chloride hydroxyethyl starch 40 can prevent hypotension during spinal-epidural anaesthesia for caesarean section.

关 键 词：剖宫产术 高渗氯化钠羟乙基淀粉40注射液 腰-硬联合麻醉 低血压 

分 类 号：R614[医药卫生—麻醉学]