持续静滴呋塞米预防围术期子痫前期相关性急性肺水肿的价值  

Application of continuous infusion of furosemide to preventing perioperative preeclampsia-related acute pulmonary edema.

作　　者：李智泉[1] 王晨虹[1] 

机构地区：[1]南方医科大学深圳市妇幼保健院产科ICU,广东深圳518028

出　　处：《中国实用妇科与产科杂志》2010年第7期540-542,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨持续静滴呋塞米预防围术期子痫前期相关性急性肺水肿的价值。方法选择2008年1月至2009年12月深圳市妇幼保健院产科ICU 68例重度子痫前期剖宫产患者,随机分为干预组(33例)和对照组(35例),对照组给予解痉治疗,干预组在此基础上于产后持续静滴呋塞米利尿治疗,比较两组手术前后、血氧饱和度、呼吸、心率、平均动脉压、围术期急性肺水肿发生率、D-二聚体及凝血功能等指标。结果干预组术后血氧饱和度(98.30±1.40)%与对照组术后(93.57±2.76)%相比,差异有统计学意义(P<0.05)。干预组术后平均动脉压(102.79±9.58)mmHg比对照组术后(117.06±8.20)mmHg明显下降,差异有统计学意义(P<0.05)。干预组围术期急性肺水肿的发生率为3.03%,明显低于对照组的19.44%,差异有统计学意义(P<0.05)。结论通过围术期子痫前期相关性急性肺水肿的干预治疗,可明显改善患者的肺功能和降低急性肺水肿的发生率,同时也有效地控制高血压。Objective To interfere with associated risk factors of pre-eclampsia related acute pulmonary edema during perioperative period to reduce the incidence of acute pulmonary edema. Methods 68 patients with severe pre-eclampsia receiving cesarean delivery were randomly divided into intervention group （ n = 33 ） and control group （ n = 35 ）. During perioperative period,control group was given conventional treatment including magnesium sulfate for seizure prophylaxis. On this basis, the intervention group was given additional continuous infusion of furosemide. We compared the clinical indicators of the two groups including oxygen saturation, respiratoryrate, heart rate, mean arterial pressure （MAP） and the incidence of acute pulmonary edema, the plasma levels of D-dimer （DD）and activated partial thromboplastin time （APTT）,prothrombin time （PT）. Results To assess the efficacy after 24 hours postpartum, The oxygen saturation in intervention group postpartum was increased significantly than that in control group postpartum [ （ 98. 30 ± 1.40） % vs （93. 57±2. 76）% （P 〈0. 05）]. The MAP in intervention group postpartum was more decreased than that in control group postpartum [ （ 102. 79 ±9. 58） mmHg vs （ 117. 06 ±8. 20） mmHg, （P 〈 0.05 ） ]. The incidence of acute pulmonary edema in intervention group was lower than that in control group （3.03% vs19. 44% ） ,the difference was statistically significant （P 〈 0.05）. Conclusion Perioperative intervention therapy for preventing patients from pre-eclampsia-related acute pulmonary edema can significantly improve the patient＇s lung function and reduce the incidence of acute pulmonary edema.

关 键 词：重度子痫前期 肺水肿 围手术期 持续静脉滴注 呋塞米 

分 类 号：R71[医药卫生—妇产科学]