预充羟乙基淀粉联合输注去氧肾上腺素预防剖宫产术中仰卧位综合征的临床效果  

Clinical effect of prefilled Hydroxyethyl starch combined with Phenylephrine infusion to prevent supine syndrome during cesarean section

作　　者：胡明秀 余王君 周柳瑜 吴刚 陈汝康 HU Ming-xiu;YU Wang-jun;ZHOU Liu-yu;WU Gang;CHEN Ru-kang(Department of Anesthesiology,Dongguan Shuixiang Central Hospital,Guangdong Province,Dongguan 523142,China;Department of Medical Quality Control,Dongguan Shuixiang Central Hospital,Guangdong Province,Dongguan 523142,China;Department of Obstetrics and Gynecology,Dongguan Shuixiang Central Hospital,Guangdong Province,Dongguan 523142,China)

机构地区：[1]广东省东莞市水乡中心医院麻醉科,广东东莞523142 [2]广东省东莞市水乡中心医院医疗质量控制科,广东东莞523142 [3]广东省东莞市水乡中心医院妇产科,广东东莞523142

出　　处：《中国当代医药》2021年第4期137-140,共4页China Modern Medicine

基　　金：广东省东莞市社会科技发展(一般)项目(201950715019433)。

摘　　要：目的探讨预充羟乙基淀粉联合输注去氧肾上腺素预防剖宫产术中仰卧位综合征发生的临床效果。方法选取2019年4月~2020年4月广东省东莞市水乡中心医院收治的108例剖宫产产妇,依据随机数表法分为A、B、C三组,每组各36例。A组于麻醉前30 min予以复方氯化钠注射液静脉滴注,B、C两组于麻醉前30 min予以羟乙基淀粉静脉滴注,C组于麻醉成功后立刻输注去氧肾上腺素。比较三组麻醉前(T_(1))、麻醉后1 min(T_(2))、麻醉后3 min(T_(3))、麻醉后5 min(T_(4))及麻醉后10 min(T_(5))的收缩压(SBP)、舒张压(DBP)、心率(HR)变化情况,新生儿1 min、5 min Apgar评分以及麻醉过程中仰卧位综合征发生率。结果三组T_(1)时SBP、DBP及HR指标比较,差异无统计学意义(P>0.05)。相较T_(1),A组SBP于T_(3)、T_(4)、T_(5)时下降,B组SBP于T_(3)、T_(4)时下降,C组SBP于T_(3)时上升,差异均有统计学意义(P<0.05)。相较T_(1),A组DBP于T_(2)、T_(3)、T_(4)时下降,B组DBP于T_(3)、T_(4)、T_(5)时下降,C组DBP于T_(3)时上升,差异均有统计学意义(P<0.05)。相较T_(1),A组HR于T_(2)、T_(3)、T_(4)、T_(5)上升,B组HR于T_(3)、T_(4)、T_(5)上升,差异均有统计学意义(P<0.05)。相较T_(1),C组HR于T_(2)、T_(3)、T_(4)、T_(5)均较稳定,差异无统计学意义(P>0.05)。相较A组,B组SBP于T_(4)时较高,C组SBP于T_(3)、T_(4)、T_(5)时较高,B组DBP于T_(4)、T_(5)时较高,C组DBP于T_(2)、T_(3)、T_(4)、T_(5)时较高,B组HR于T_(3)、T_(4)时较低,C组HR于T_(2)、T_(3)、T_(4)、T_(5)时较低,差异均有统计学意义(P<0.05);相较B组,C组SBP于T_(2)、T_(3)、T_(4)、T_(5)时较高,C组DBP于T_(2)、T_(3)、T_(4)时较高,C组HR于T_(2)、T_(3)、T_(4)时较低,差异有统计学意义(P<0.05)。C组新生儿1 min Apgar评分高于A、B两组,差异有统计学意义(P<0.05);三组新生儿5 min Apgar评分均高于1 min Apgar评分,差异有统计学意义(P<0.05);三组新生儿的5 min Apgar评分比较,差异无统计学意�Objective To explore the clinical effect of prefilled Hydroxyethyl starch combined with Phenylephrine infusion to prevent the occurrence of supine syndrome during cesarean section.Methods A total of 108 women accepting cesarean section admitted to Dongguan Shuixiang Central Hospital from April 2019 to April 2020 were selected.According to the random number table method,they were divided into three groups,A,B and C,with 36 cases in each group.In group A,compound sodium chloride injection in intravenous drip was used 30 min before anesthesia.In group B and C,intravenous drip of Hydroxyethyl starch 30 min before anesthesia was applied,and in group C,Phenylephrine was immediately added after successful anesthesia.The changes of systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)of the three groups before anesthesia(T_(1)),1 min after anesthesia(T_(2)),3 min after anesthesia(T_(3)),5 min after anesthesia(T_(4))and 10 min after anesthesia(T_(5)),1 min and 5 min Apgar score of newborns,and incidence of supine syndrome during anesthesia were compared.Results There were no significant differences in SBP,DBP and HR indicators among the three groups at T_(1)(P>0.05).Compared with T_(1),the SBP of group A decreased at T_(3),T_(4),and T_(5),the SBP of group B decreased at T_(3) and T_(4),the SBP of group C increased at T_(3),the differences were statistically significant(P<0.05).Compared with T_(1),the DBP of group A decreased at T_(2),T_(3),and T_(4),the DBP of group B at T_(3),T_(4),and T_(5) decreased,the DBP of group C increased at T_(3),the differences were statistically significant(P<0.05).Compared with T_(1),the HR of group A increased at T_(2),T_(3),T_(4),and T_(5),the HR of group B increased at T_(3),T_(4),T_(5),the differences were statistically significant(P<0.05).Compared with T_(1),HR of group C was more stable at T_(2),T_(3),T_(4),T_(5),and the difference was not statistically significant(P>0.05).Compared with group A,the SBP of group B was higher at T_(4),in group C was higher at T_(3),

关 键 词：仰卧位综合征 羟乙基淀粉 去氧肾上腺素 剖宫产 

分 类 号：R614[医药卫生—麻醉学]