产妇托架对腰麻下剖宫产术无创血流动力学的影响  

Effect of brackets on non-invasive hemodynamics of parturients during caesarean section under spinal anesthesia

作　　者：张加强[1] 孟凡民[1] 姚翔燕[1] 孙燕[2] 

机构地区：[1]河南省人民医院麻醉科,河南郑州450003 [2]郑州市妇幼保健院,河南郑州450012

出　　处：《军医进修学院学报》2012年第4期325-327,共3页Academic Journal of Pla Postgraduate Medical School

基　　金：河南省医学科技攻关项目(200801010)

摘　　要：目的观察产妇托架对腰麻下剖宫产术产妇无创血流动力学的影响。方法选择40例择期行剖宫产术的产妇,随机分为2组,实验组(Ⅰ)20例麻醉后应用自行研制产妇托架并用压力传感器测腹部压托板的压力,对照组(Ⅱ)20例麻醉后手术床左倾15°。连接BioZ.com无创血流动力学监测仪连续监测血流动力学变化,记录两组在麻醉前(T1)、麻醉后平卧1min(T2)、3min(T3)、5min(T4)、10min(T5)、胎儿取出前1min(T6)、胎儿取出后3min(T7)、术毕(T8)各时间点的心率(HR)、平均动脉压(MAP)、每搏输出量(SV)、心排量(CO)、胸腔液体量(TFC)、心肌加速指数(ACI)、体循环阻力(SVR)的变化情况。记录两组注腰麻药即刻至切开子宫时间和麻醉手术时间。结果两组T2的MAP、CO差异有统计学意义(P<0.05),T3、T4的MAP差异有统计学意义(P<0.01),T4的TFC差异有统计学意义(P<0.05);T3-T8时间点的ACI、SV及CO两组差异均有统计学意义(P<0.05或0.01);T5-T8时点的TFC两组差异均有统计学意义(P<0.01)。对照组发生低血压6例,占30.0%;实验组发生1例,占5.0%,两组比较差异有统计学意义(P<0.05)。结论使用产妇托架能保持腰麻后孕产妇血流动力学相对稳定,减少低血压的发生。Objective To study the effect of brackets on non-invasive hemodynamics of parturients during caesarean section under spinal anesthesia.Methods Forty parturients who underwent cesarean section under spinal anesthesia were randomly divided into control group and experimental group.Pressures of abdominal brackets on parturients in control group placed on a left-leaning operating table at 15°and those in experimental group with abdominal bracket after spinal anesthesia were measured using a pressure sensor.Hemodynamic change was consecutively monitored using the BioZ.com system connected to the parturients.Heart rate（HR）,mean arterial pressure（MAP）,stroke volume（SV）,cardiac output（CO）,thoracic fluid content（TFC）,cardiac acceleration index（ACI）,systemic vascular resistance（SVR） were recorded before anesthesia（T1）,1 minute（T2）,3 minutes（T3）,5 minutes（T4）,10 minutes（T5） after anesthesia,and 1 minute（T6） before cesarean delivery,3 minutes（T7） after cesarean delivery and at the end of operation（T8）.The time from spinal anesthesia to skin incision and the operation time were recorded.Results The MAP and CO at T2,T3,T4,the TFC at T4,the SV,CO,ACI and TFC at T3,T4,T5,T6,T7,T8 were significantly higher in experimental group than in control group（P0.01）.The incidence of hypotension was higher in control group than in experimental group（30.3% vs 5.0%,P0.01）.Conclusion The application of bracket in parturients can maintain their hemodynamics at a relative stabile level and reduce the incidence of hypotension after spinal anesthesia.

关 键 词：剖宫产术 腰麻 血液动力学 低血压 

分 类 号：R719.8[医药卫生—妇产科学]