右美托咪定对使用血管活性药防治仰卧位低血压产妇肾功能的影响  

The effect of Dexmedetomidine on renal function of puerpera with hypotension in supine position with vasoactive drugs

作　　者：黄敏坚[1] 黄贞[1] Huang Minjian;Huang Zhen(The People's Hospital of Baise City,Baise,Guangxi 533000)

机构地区：[1]百色市人民医院,广西百色533000

出　　处：《基层医学论坛》2021年第19期2696-2698,共3页The Medical Forum

基　　金：百色市科学研究与技术开发计划课题(百科20192526,百科20193215)。

摘　　要：目的探讨右美托咪定(Dex)对使用血管活性药防治仰卧位低血压产妇肾功能的影响。方法选择2019年8月—2021年2月于我院行剖宫产术的产妇200例,按随机数字表法分为生理盐水(NS)组(100例)、Dex组(100例)。Dex组静脉推注Dex,NS组静脉推注等量生理盐水,比较2组血流动力学指标、肾功能、仰卧位低血压综合征(SHS)及新生儿窒息发生率。结果2组T0时HR、SBP水平及术前NGAL水平对比,无统计学差异(P>0.05);Dex组T1时的HR(94.17±4.03)次/min,低于NS组的(105.41±6.39)次/min,SBP(102.19±8.42)mm Hg,高于NS组的(81.43±6.58)mm Hg(P<0.05),Dex组术后中性粒细胞明胶酶相关脂质运载蛋白(NGAL)(39.51±3.95)ng/mL,低于NS组的(41.82±2.07)ng/mL,SHS发生率(5.00%)低于NS组(14.00%),有统计学差异(P<0.05);2组新生儿窒息发生率对比,无统计学差异(P>0.05)。结论Dex用于剖宫产手术中有利于降低SHS发生率,稳定产妇血流动力学,保护肾功能,且对新生儿无明显影响,可作为腰硬联合麻醉下剖宫产手术中一种安全有效的麻醉辅助药物。Objective To investigate the effect of dexmedetomidine(Dex)on renal function of vasoactive drugs in the prevention and treatment of supine hypotension.Methods 200 cases of parturients who underwent cesarean section in our hospital from August 2019 to February 2021 were selected and divided into normal saline(NS)group(100 cases)and Dex group(100 cases)according to the random number table method.Dex group received intravenous bolus of Dex,and NS group received intravenous bolus of the same amount of normal saline.The hemodynamic indexes,renal function,supine hypotension syndrome(SHS),and incidence of neonatal asphyxia were compared between the two groups.Results There was no statistical difference between the two groups of HR,SBP levels at T0 and preoperative NGAL levels(P>0.05);the HR at T1 of the Dex group was(94.17±4.03)times/min,which was lower than that of the NS group(105.41±6.39)Times/min,SBP(102.19±8.42)mmHg,higher than(81.43±6.58)mmHg in the NS group.Postoperative neutrophil gelatinase-associated lipocalin(NGAL)(39.51±3.95)ng/mL in the Dex group was lower than that in the NS group(41.82±2.07)ng/mL,and the incidence of SHS(5.00%)was lower than In the NS group(14.00%),there was a statistical difference(P<0.05);there was no statistical difference in the incidence of neonatal asphyxia between the two groups(P>0.05).Conclusion Dex used in cesarean section is beneficial to reduce the incidence of SHS,stabilize maternal hemodynamics,protect renal function,and has no obvious effect on neonates.Dex can be used as a kind of cesarean section under combined spinal-epidural anesthesia Safe and effective anesthesia supplementary drugs.

关 键 词：仰卧位低血压综合征 血管活性药 右美托咪定 血流动力学 肾功能 

分 类 号：R4[医药卫生—临床医学]