小剂量瑞芬太尼抑制重度子痫前期剖宫产术患者气管插管反应的效果观察及对新生儿的影响  

Observation on the effects of Low-dose remifentanil on inhibition of tracheal intubation response in the patients with severe preeclampsia under cesarean section and its effect on neonatal

作　　者：张素芹 徐文平[1] 任铭[1] 陈静 张引法 

机构地区：[1]浙江省嘉兴市妇幼保健院麻醉科,浙江嘉兴314000

出　　处：《中国现代医生》2018年第3期103-106,共4页China Modern Doctor

基　　金：浙江省嘉兴市科技计划项目(2017AY33045)

摘　　要：目的探讨瑞芬太尼抑制重度子痫前期剖宫产术患者气管插管反应的有效剂量及对新生儿的影响。方法将100例重度子痫前期剖宫产患者用随机数字表法分为五组,A组瑞芬太尼剂量为0.25μg/kg,B组为0.50μg/kg,C组0.75μg/kg,D组1.00μg/kg,E组1.25μg/kg。进行血气分析、新生儿阿氏评分、收缩压和心率观察,统计有效率,分析半数有效剂量和有效剂量。结果五组血气分析结果及新生儿阿氏评分比较,差异无统计学意义(P均>0.05);插管前各组收缩压、心率均较基础值低,差异有统计学意义(P<0.05);插管后D组、E组收缩压、心率较基础值低,A组、B组较基础值高,差异有统计学意义(P<0.05);分娩时各组收缩压、心率均低于基础值。插管后A组、B组、C组收缩压、心率及胎儿娩出时A组、B组、C组、D组收缩压、心率均高于E组,差异有统计学意义(P<0.05)。A、B、C、D、E各组有效率分别为15.00%、45.00%、65.00%、75.00%、90.00%(P=0.0000);ED50为0.64μg/kg(95%CI 0.52~0.74),ED95为1.32μg/kg(95%CI 1.08~1.70μg/kg)。结论瑞芬太尼能有效抑制子痫前期剖宫产气管插管反应,应提前准备复苏设备以及时处理使用后新生儿短暂呼吸抑制。Objective To investigate the effective dose of remifentanil in inhibition of tracheal intubation response in the patients with severe preeclampsia under Cesarean section and its effect on newborn infants. Methods A total of 100 cases of severe preeclampsia under Cesarean section were divided into 5 groups according to the random number table. The remifentanil dose in group A was 0.25 μg/kg, the dose in group B was 0.50 μg/kg, the dose in group C was 0.75 μg/kg, the dose in group D was 1.00 μg/kg, and the dose in group E was 1.25 μg/kg. Blood gas analysis, neonatal Apgar score, systolic blood pressure and heart rate were observed. The efficiency was statistically analyzed, and the half effective dose and effective dose were analyzed. Results The results of blood gas analysis and neonatal Apgar scores in 5 groups were compared（P〉0.05 for all）; before intubation, the systolic blood pressure and heart rate in each group were lower than the baseline values, and the difference was statistically significant（P〈0.05）; after intubation, the systolic blood pres- sure and heart rate in group D and group E were lower than the baseline values, and they were higher than the basic values in group A and group B, with significant difference（P〈0.05）; the systolic blood pressure and heart rate in each group during labor were lower than the baseline values. After intubation, the systolic blood pressure and heart rate in group A, group B and group C and the systolic blood pressure and heart rate in group A, B, C and D during delivery were all significantly higher than those in group E, and the differences were statistically significant（P〈0.05）. The effective rates in group A, B, C, D and E were 15.00%, 45.00%, 65.00%, 75.00% and 90.00% respectively（P=0.0000）; ED50 was 0.64 μg/kg（95% CI 0.52-0.74）, and ED95 was 1.32 μg/kg（95%Cl 1.08-1.70 μg/kg）. Conclusion Remifentanil can ef- fectively inhibit the tracheal intubation response in preeclampsia under Cesarean section. Resuscitation equipment sh

关 键 词：瑞芬太尼 重度子痫前期 气管插管反应 小剂量 新生儿呼吸抑制 

分 类 号：R614.2[医药卫生—麻醉学]