盐酸麻黄碱皮下浸润联合晶体共负荷预防剖宫产腰麻后低血压的效果分析  

Effect Analysis of Subcutaneous Infiltration of Ephedrine Hydrochloride Combined with Crystal Co-loading on Preventing Hypotension after Lumbar Anesthesia in Cesarean Section

作　　者：张雪苗 岳圆圆 赵文琪 范修颖 张月顺 ZHANG Xuemiao;YUE Yuanyuan;ZHAO Wenqi;FAN Xiuying;ZHANG Yueshun(Mudanjiang Medical University,Mudanjiang 157000,China)

机构地区：[1]牡丹江医学院,黑龙江牡丹江157000 [2]牡丹江医学院附属红旗医院

出　　处：《中国医学创新》2021年第22期17-21,共5页Medical Innovation of China

摘　　要：目的:观察盐酸麻黄碱与1%利多卡因混合皮下逐层浸润联合晶体液共负荷预防剖宫产产妇腰麻后低血压的效果以及对新生儿的影响。方法:选取牡丹江市妇女儿童医院2019年10月-2020年1月收入院的60例择期在腰麻下行剖宫产产妇。根据电脑生成的随机数字,按随机数字表法将产妇随机分为C组和E组,每组30例。C组采用晶体共负荷,E组采用晶体共负荷联合盐酸麻黄碱皮下浸润。比较两组各时间点MAP、HR水平和并发症发生情况。比较两组静脉应用盐酸麻黄碱剂量,比较两组新生儿的酸中毒及Apgar评分情况。结果:T_(4)~T_(8),E组的MAP均明显高于C组,差异均有统计学意义(P<0.05);T_(0)~T3,两组的MAP、HR比较,差异均无统计学意义(P>0.05);T_(4)~T_(8),两组的HR比较,差异均无统计学意义(P>0.05)。E组低血压发生率为33.3%,低于C组的63.3%,差异有统计学意义(P<0.05);E组恶心发生率为13.3%,低于C组的36.7%,差异有统计学意义(P<0.05);两组反应性高血压、呕吐发生率比较,差异均无统计学意义(P>0.05);C组静脉应用盐酸麻黄碱的总剂量明显高于E组,差异有统计学意义(P<0.05)。E组的pH明显高于C组,碱剩余、乳酸均明显优于C组,差异均有统计学意义(P<0.05);新生儿的1、5 min Apgar评分比较,差异均无统计学意义(P>0.05)。结论:盐酸麻黄碱皮下浸润联合晶体液共负荷用于预防腰麻后低血压,血流动力学稳定,无明显反应性高血压,对新生儿影响较小,可以作为一种安全、有效的预防手段。Objective:To observe the effect of Ephedrine Hydrochloride and 1% Lidocaine mixed subcutaneous layer by layer infiltration combined with crystal co-loading on the prevention of hypotension after lumbar anesthesia in cesarean section parturients and its effect on neonates.Method:A total of 60 parturients who received cesarean section under lumbar anesthesia were selected from Mudanjiang Women’s and Children’s Hospital from October 2019 to January 2020.According to the computer generated random numbers,the parturient women were randomly divided into group C and group E according to the random number table method,30 cases in each group.Group C was treated with crystal co-loading,while group E was treated with crystal co-loading combined with Ephedrine Hydrochloride subcutaneous infiltration.MAP,HR level and complications were compared between the two groups at each time point.The dose of intravenous Ephedrine Hydrochloride was compared between the two groups,the acidosis and Apgar score of neonates in the two groups were compared.Result:T_(4) to T_(8),the MAP of group E were significantly higher than those of group C,the differences were statistically significant (P<0.05).T_(0) to T_(3),comparison of MAP and HR between the two groups,there were no statistical significance between the two groups (P>0.05).T_(4) to T_(8),comparison of HR between the two groups,there were no statistically significant differences (P>0.05).The incidence of hypotension in group E was 33.3%,which was lower than 63.3% in group C,the difference was statistically significant (P<0.05).The incidence of nausea in group E was 13.3%,compared with 36.7% in group C,the difference was statistically significant (P<0.05).The incidences of reactive hypertension and vomiting were compared between the two groups,the differences were not statistically significant (P>0.05).The total dose of intravenous Ephedrine Hydrochloride in group C was significantly higher than that in group E,the difference was statistically significant (P<0.05).The pH of group E w

关 键 词：低血压 蛛网膜下腔麻醉 剖宫产 盐酸麻黄碱 晶体共负荷 

分 类 号：R614[医药卫生—麻醉学]