超声观察去氧肾上腺素防治剖宫产术低血压时对子宫-胎盘血流的影响  

Observations on Effect of Phenylephrine on Uterine and Placental Haemodynamics Following Spinal Anesthesia During Cesarean Section with Ultrasonography

作　　者：薛勤[1] 郭然[2] 邹大中[1] 谭洁[3] 蒋美琴[3] 

机构地区：[1]东南大学医学院附属江阴医院超声科,江苏省江阴市214400 [2]东南大学医学院附属江阴医院麻醉科,江苏省江阴市214400 [3]东南大学医学院附属江阴医院妇产科,江苏省江阴市214400

出　　处：《中国超声医学杂志》2018年第1期47-50,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用彩色多普勒超声观察去氧肾上腺素防治剖宫产术腰麻后低血压时子宫-胎盘血流动力学变化。方法选择拟行剖宫产的单胎足月产妇68例,腰麻后持续泵注去氧肾上腺素25μg/min,将收缩压控制在80%~100%基线值范围。应用超声观察麻醉前后孕妇子宫动脉及胎儿脐动脉的血流动力学参数(PSV、EDV、PI、RI、S/D)。结果与麻醉前比较,麻醉后产妇子宫动脉PI及S/D值虽升高(P<0.05),但仍于正常值范围,且麻醉前后胎儿脐动脉血流动力学参数差异比较无统计学意义(P>0.05)。结论应用去氧肾上腺素防治腰麻下剖宫产术产妇低血压时并不影响子宫-胎盘血流灌注。Objective To observe the effect of phenylephrine on uterine and placental haemodynamics when use for the prevention or treatment of hypotension following spinal anesthesia during cesarean section with ultrasonogra- phy. Methods We selected sixty-eight in-term parturients with singleton scheduled for selective cesarean sec- tion. After the completion of subarachnoid injection, parturients were received a phenylephrine infusion at a fixed rate of 25 /~g/min, This infusion was titrated to maintain maternal baseline systolic blood pressure （SBP）, uterine artery vascular resistance （Pl,RI,S/D） were recorded before spinal anesthesia and at 5 min after the subarachnoid injection with ultrasonography, and umbilical artery vascular resistance （PI, RI, S/D）were recorded spinal anesthesia at 7 min after the subarachnoid injection. Results Before and after phenylephrine infusing, the haemodynamics of umbilical vascular showed no evident differenee（P〉0.05）. Although uterine artery S/D, PI values increased after phenylephrine infusing（P〈0.05）, they were still in the normal range. Conclusions When phenylephrine was used for the preven- tion or treatment of hypotension following spinal anesthesia during cesarean section, there was no change in uterine and placental haemodynamics.

关 键 词：去氧肾上腺素 脐动脉 子宫动脉 超声 腰麻 剖宫产术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R719.8[医药卫生—诊断学]