去氧肾上腺素对腰硬联合麻醉下行剖宫产术产妇子宫收缩力的影响  

Effect of phenylephrine on uterine contractility of women undergoing Cesarean section under combined spinal and epidural anesthesia

作　　者：殷颖 刘功俭 YIN Ying;LIU Gong-jian(Xuzhou Medical University,Xuzhou Jiangsu 221000)

机构地区：[1]徐州医科大学研究生院,江苏徐州221000

出　　处：《中南药学》2020年第5期869-872,共4页Central South Pharmacy

摘　　要：目的探讨静脉注射临床常用浓度的去氧肾上腺素是否影响行剖宫产术产妇的子宫收缩力。方法选择2019年1月1日至2019年9月30日在徐州医科大学附属医院择期行腰硬联合麻醉下剖宫产的142例健康初产妇作为研究对象,年龄20~35岁,单胎,足月待产,ASA分级Ⅰ~Ⅱ级。根据术中是否使用去氧肾上腺素分为使用去氧肾上腺素组(P组)和未使用去氧肾上腺素组(G组)。记录术后24 h阴道出血量;记录术中胎盘娩出时间、术中缩宫素补救情况、术中缩宫素使用量、术后1 h阴道出血量、术后24 h内促宫缩药物补救情况、术前与术后血红蛋白变化以及产后出血情况。结果两组患者术后24 h、1 h阴道出血量、胎盘娩出时间、术中缩宫素补救、术中缩宫素使用量、术前与术后血红蛋白差值、术后24 h促宫缩药物使用情况以及产后出血差异无统计学意义。结论静脉注射临床常用浓度的去氧肾上腺素不会抑制剖宫产术中产妇子宫收缩力。Objective To determine whether intravenous phenylephrine commonly used in clinical settings affects the uterine contractility.Methods Totally 142 healthy primiparas were included in the study who underwent Cesarean section under combined spinal and epidural anesthesia in the Affiliated Hospital of Xuzhou Medical University from January 1st,2019 to September 30th,2019,aged 20~35 years,single birth,fullterm production,ASA physical statusⅠorⅡ.According to whether phenylephrine was used during the surgery,these primiparas were divided into a phenylephrine group(group P),and a non-phenylephrine group(group G).The vaginal hemorrhage 24 hours after the operation,time of placenta delivery,rescue of oxytocin,intraoperative oxytocin dosage,vaginal hemorrhage of one hour after the operation,remission of uterine contractions within 24 hours after the surgery,preoperative and postoperative change of hemoglobin,and postpartum hemorrhage were recorded.Results There was no significant difference in vaginal bleeding,time of placenta delivery,rescue of oxytocin,intraoperative oxytocin use,preoperative and postoperative hemoglobin difference,and postoperative refractory drug use 24 h after the surgery.Conclusion Intravenous injection of phenylephrine at clinical concentrations does not inhibit the uterine contractility during Cesarean section.

关 键 词：腰硬联合麻醉 剖宫产 子宫收缩力 去氧肾上腺素 前瞻性队列研究 

分 类 号：R614[医药卫生—麻醉学]