血管活性药物防治剖宫产腰麻后低血压的研究进展  

Research Progress of Vasoactive Drugs in Prevention and Treatment for Hypotension after Spinal Anesthesia for Cesarean Section

作　　者：张悦[1] 冯善武[1] ZHANG Yue;FENG Shanwu(Department of Anesthesiology,Women′s Hospital of Nanjing Medical University/Nanjing Maternity and Child Health Care Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)麻醉科,南京210000

出　　处：《医学综述》2022年第17期3462-3466,共5页Medical Recapitulate

基　　金：国家自然科学基金(81971045)。

摘　　要：剖宫产术中腰麻后交感神经阻滞、血管扩张引起的低血压非常常见,除了导致母体胸闷、恶心等不良体验,还可能造成胎盘血流减少、胎儿缺氧,最终导致新生儿不良酸碱结局,因此有效防治低血压十分必要。术中使用血管活性药物是临床防治低血压的常用方式,既往指南推荐的一线药物麻黄碱和去氧肾上腺素均存在一定的不良反应,使其临床应用受到限制,因此探索更为安全的血管活性药物有助于改善母婴结局。高危产妇人群在血管活性药物的选择上应更加个体化,根据并发症和合并症调整用药,保障母婴安全。Hypotension caused by sympathetic nerve block and vascular dilation after spinal anesthesia during cesarean section is very common.In addition to causing maternal chest tightness,nausea,and other adverse experiences,it may also cause decrease of placental blood flow,fetal hypoxia,and eventually lead to adverse acid-base outcomes of the newborns.Therefore,it is necessary to effectively prevent and treat hypotension.Vasoactive agents are commonly used in prevention and treatment of hypotension clinically.The use of ephedrine and phenylephrine,the first-line drugs recommended by previous guidelines,has been restricted due to certain adverse reactions.Therefore,further exploration of safer vasoactive agents may help to improve the maternal and infant outcomes.The selection of vasoactive agents for the high-risk maternal population should be more individualized according to complications to ensure the safety of mothers and infants.

关 键 词：腰麻后低血压 剖宫产术 血管活性药物 高危产妇 

分 类 号：R614[医药卫生—麻醉学]