剖宫产术中输注去氧肾上腺素对新生儿的影响  

Influence of phenylephrine infusion during caesarean section on newborns

作　　者：韩旭东[1] 范坤[2] 平春枝[2] 耿智隆[3] 张小兰[2] 

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730050 [2]甘肃省妇幼保健院麻醉科,甘肃兰州730050 [3]兰州军区兰州总医院麻醉科,甘肃兰州730050

出　　处：《中国妇幼健康研究》2015年第1期58-59,62,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨剖宫产术中不同速度去氧肾上腺素预防性静脉输注对新生儿血气的影响。方法收集2012年9月至2013年1月在甘肃省妇幼保健院行择期剖宫产术产妇150例,采用随机数字表法将产妇分为6组,每组25例:P1、P2、P3、P4(去氧肾上腺素预防性泵注组)、E(麻黄碱预防性推注组)、C(对照组)。腰麻完成平卧后,对P1~P4组产妇分别即刻静脉泵注0.1、0.2、0.3、0.4μg·kg^(-1)·min^(-1)去氧肾上腺素10min;E组平卧后即刻静脉注射麻黄碱10mg;C组无预处理。监测新生儿Apgar评分及脐动脉血气指标,并进行分析。结果与E、C组比较,P1~P4组pH值较高(F=4.70,P<0.05);与C组比较,P1~P4组及E组的脐动脉血氧分压较高(F=5.80,P<0.01)。各组新生儿出生后1、5min Apgar评分比较均无统计学差异(均P>0.05)。结论与使用麻黄碱相比,剖宫产术中预防性静脉持续输注去氧肾上腺素能增加新生儿脐动脉血的pH值,但对Apgar评分无明显影响。不同速度去氧肾上腺素泵注亦不影响新生儿pH及Apgar评分。Objective To explore the influence of prophylactic infusion of phenylephrine with different speed during caesarean section on neonatal blood gas. Methods From September 2012 to January 2013 a total of 150 women undergoing elective cesarean section in Gansu Provincial Maternity and Child-care Hospital were selected, and they were randomly divided into 6 groups with 25 cases in each, group P1, group P2, group P3, group P4 （phenylephrine groups）, group E （ephedrine group） and group C （control group）. Group P1, group P2, group P3 and group P4 received infusion of phenylephrine in rate of 0. 1, 0.2, 0.3 and 0.4μg·kg^-1·min^-1 , respectively, for 10 minutes after spinal anesthesia. Group E received prophylactic ephedrine 10mg intravenous administration after spinal anesthesia. Group C was not given prophylactic vasopressor. Apgar score and umbilical arterial blood gas were monitored for analysis. Results Compared with group E and group C, pH of group P1, group P2, group P3 and group P4 was relatively higher （ F = 4.70, P 〈 0.05 ）. Compared with group C, PO2 in group P1, group P2, group P3 and group P4 and group E was significant higher （F = 5.80 ,P 〈 0.01 ）. There was no significant difference in lmin and 5min Apgar score of newborns among all groups （all P 〉 0.05 ）. Conclusion Prophylactic infusion of phenylephrine during caesarean section increases pH of umbilical arterial blood compared with ephedrine, but it does not affect Apgar score of newborns remarkably. Meanwhile, no difference in pH of umbilical arterial blood and Apgar score of newborns is found among phenylephrine groups with different infusion rate.

关 键 词：去氧肾上腺素 剖宫产术 新生儿 血气分析 

分 类 号：R614.41[医药卫生—麻醉学]