不同血浆靶浓度下输注丙泊酚预防剖宫产术中卡前列素氨丁三醇不良反应的临床研究  

Clinical study of prophylactic propofol on the side effects of carboplatin and trometamol infusion at different plasma target concentrations in cesarean section

作　　者：占霖森[1] 兰允平[1] 夏昌兴[1] 余功敏[1] Zhan Linsen;Lan Yunping;Xia Changxing;Yu Gongmin(Department of Anesthesiology,the People's Hospital of Quzhou,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市人民医院麻醉科,浙江省衢州324000

出　　处：《中国基层医药》2018年第23期3086-3090,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察不同血浆靶浓度下输注丙泊酚预防剖宫产术中卡前列素氨丁三醇不良反应的效果。方法选取2016年1月至2017年10月衢州市人民医院184例剖宫产孕妇进行前瞻性研究,采用随机数字表法分为A组、B组、C组及对照组(N组)各46例。A、B、C三组均靶控输注丙泊酚,浓度分别为0.8 μg/mL、1.2 μg/mL、1.6 μg/mL,N组以0.5 mL·kg^-1·h^-1的速率输注0.9%氯化钠注射液。比较四组手术时间、术中出血量及补液量、血压升高、血压降低、心动过速发生率及不良反应发生率。结果四组手术时间分别为(46.65±5.32)min、(49.21±4.75)min、(48.74±4.28)min、(49.76±5.25)min,组间比较差异均无统计学意义(F=1.501,P>0.05);四组术中出血量分别为(425.66±39.54)mL、(428.71±41.03)mL、(427.96±41.55)mL、(431.56±42.35)mL,组间比较,差异均无统计学意义(F=1.882,P>0.05);四组术中补液量分别为(884.59±51.22)mL、(879.20±47.63)mL、(883.59±50.14)mL、(896.33±50.23)mL,组间比较,差异均无统计学意义(F=1.634,P>0.05)。B组镇静满意率达91.30%,显著高于A组的58.70%和C组的30.43%(Z=91.428,P<0.05)。B组与C组的心血管事件发生率均显著低于A组(均P<0.05),同时B组低于C组(P<0.05)。四组胸闷、头痛、面部潮红发生率差异均无统计学意义(χ^2=3.450、4.816、5.396,均P>0.05)。B组恶心与呕吐发生率分别为8.70%与4.35%,C组恶心与呕吐发生率分别为8.70%与2.17%,均显著低于A组的26.09%与19.57%,组间比较差异均有统计学意义(χ^2=7.485、10.405,均P<0.05)。 结论靶控输注1.2 μg/mL的丙泊酚可有效预防剖宫产术中卡前列素氨丁三醇的不良反应,且镇静效果佳。Objective To observe the effect of propofol infusion on the side effects of carboplatin and trometamol at different plasma target concentrations in cesarean section.Methods From January 2016 to October 2017,a total of 184 cases of cesarean section pregnant women in the People′s Hospital of Quzhou were selected for prospective study.They were divided into A group,B group,C group and control group(N group) according to random number table method,with 46 cases in each group.The A,B,C three groups were target-controlled infusion of propofol,the concentrations were 0.8μg/mL,1.2μg/mL,1.6μg/mL,respectively,while N group was infused 0.9% sodium chloride injection at the rate of 0.5mL·kg-1·h-1.The operative time,intraoperative blood loss,fluid replacement,elevated blood pressure,decreased blood pressure,the incidence of tachycardia and adverse reactions were compared among the four groups.Results The operation time of the four groups were (46.65±5.32)min,(49.21±4.75)min,(48.74±4.28)min,(49.76±5.25)min,respectively,the differences were not statistically significant(F=1.501,P>0.05). The volume of intraoperative blood loss in the four groups were (425.66±39.54)mL,(428.71±41.03)mL,(427.96±41.55)mL,(431.56±42.35)mL,respectively,the differences were not statistically significant(F=1.882,P>0.05). The fluid replacement in the four groups were (884.59±51.22)mL,(879.20±47.63)mL,(883.59±50.14)mL,(896.33±50.23)mL,respectively,the differences were not statistically significant(F=1.634,P>0.05). The satisfaction rate of sedation in B group was 91.30%,which was significantly higher than 58.70% in A group and 30.43% in C group(Z=91.428,P<0.05). The incidence rates of cardiovascular events in B group and C group were significantly lower than those in A group(all P<0.05),which in B group were lower than those in C group(all P<0.05). There were no statistically significant differences in chest tightness,headache,facial flushing incidence in the three groups (χ^2=3.450,4.816,5.396,all P>0.05). The incidence rates of nausea

关 键 词：剖宫产术 靶浓度 靶控输注 丙泊酚 卡前列素氨丁三醇 药物副反应报告系统 Logistic模型 RAMSAY镇静评分 

分 类 号：R614[医药卫生—麻醉学]