右美托咪定联合长托宁降低COVID-19感染后近期行剖宫产术中欣母沛不良反应的效果  

Effect of dexmedetomidine combineed with penehyclidine in preventing adverse reactions of Hemabate during cesarean section after COVID-19 infection

作　　者：韩金凤 卢春娇 姚飞 周波 施勤[1] 张邓新 何俊 HAN Jinfeng;LU Chunjiao;YAO Fei;ZHOU Bo;SHI Qin;ZHANG Dengxin;HE Jun(Department of Anesthesiology,Wuxi Maternity and Child Health Care Hospital,Jiangsu Province,Women′s Hospital of Jiangnan University,Jiangnan University,Wuxi 214002)

机构地区：[1]江苏省无锡市妇幼保健院,江南大学附属妇产医院麻醉科,无锡214002

出　　处：《南通大学学报（医学版）》2023年第3期261-264,共4页Journal of Nantong University(Medical sciences)

基　　金：无锡市卫健委重大科研项目(Z202211),无锡市妇幼健康适宜技术推广项目(FYTG202201)。

摘　　要：目的:探究右美托咪定联合长托宁预防新型冠状病毒感染(corona virus disease 2019,COVID-19)近期剖宫产术中欣母沛不良反应的效果。方法:选取COVID-19感染后足月妊娠行剖宫产术中需要使用欣母沛的产妇80例,随机分为对照组(N组)与观察组(DP组),每组40例。DP组于胎儿娩出后静脉泵注右美托咪定0.8μg/(kg·h)+静脉注射长托宁0.5 mg(生理盐水稀释至2 mL),N组静脉泵注生理盐水+静脉注射生理盐水2 mL。记录产妇入室时(T0)、注射欣母沛前(T1)、欣母沛注射后10 min(T2)及欣母沛注射后30 min(T3)的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、呼吸频率(respiratory rate,RR)及SpO_(2)水平;手术结束前行Ramsay镇静评分;记录欣母沛注射2 h内产妇发生胸闷、恶心呕吐、头晕头痛、面部潮红、腹泻等不良反应情况。结果:T0及T1时,两组产妇MAP、HR、RR及SpO_(2)比较差异均无统计学意义(均P>0.05),T2及T3时,DP组产妇MAP、HR及RR明显低于N组,SpO_(2)明显高于N组(P<0.05);DP组产妇Ramsay镇静评分明显高于N组(P<0.05);与N组比较,DP组产妇胸闷、恶心呕吐、头晕头痛、面部潮红、腹泻等不良反应发生率明显降低(P<0.05)。结论:右美托咪定联合长托宁可减轻产妇COVID-19感染后近期行剖宫产术中使用欣母沛的不良反应,血流动力学更稳定。Objective:To study the effect of dexmedetomidine combine with penehyclidine in preventing adverse reactions of Hemabate during cesarean section after corona virus disease 2019(COVID-19)infection.Methods:Select 80 cases of full-term pregnant woman after COVID-19 infection who need to use Hemabate during cesarean section,randomLy divided into control group(group N)and observation group(group DP),with 40 cases in each group.In the group DP,the dose of dexmedetomidine 0.8μg/(kg·h)and penehyclidine 0.5 mg(diluted to 2 mL of normal saline)were pumped intravenously after delivery,while in the group N,normal saline was pumped in the same way and normal saline 2 mL was administered.The levels of mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and SpO_(2) were recorded at the time of admission(T0),before injection of Hemabate(T1),10 minutes after injection of Hemabate(T2)and 30 minutes after injection of Hemabate(T3);at the end of operation,the Ramsay sedation score was implemented;the adverse reactions of chest tightness,nausea and vomiting,dizziness,headache,facial flushing,diarrhea were recorded within 2 hours after injection of Hemabate.Results:At the T0 and T1,there was no significant difference in MAP,HR,RR and SpO_(2) between the two groups(P>0.05),and at the T2 and T3,MAP,HR and RR in group DP were significantly lower than those in group N,and SpO_(2) was significantly higher than that in group N(P<0.05);the Ramsay sedation score in group DP was significantly higher than that in group N(P<0.05);compared with group N,the adverse reactions of chest tightness,nausea and vomiting,dizziness and headache,facial flushing and diarrhea in group DP were significantly lower(P<0.05).Conclusion:Dexmedetomidine combined with penehyclidine can reduce the adverse reactions of Hemabate during cesarean section after COVID-19 infection,and the hemodynamics are more stable.

关 键 词：新型冠状病毒肺炎感染 剖宫产 欣母沛 右美托咪定 长托宁 不良反应 

分 类 号：R614[医药卫生—麻醉学]