剖宫产术中应用不同剂量甲氧明的临床效果比较  

Comparison of the Clinical Effects of Intravertebral Anesthesia with Different Doses of Methotrexate in Cesarean Section

作　　者：朱芳 ZHU Fang(Department of Anesthesiology,Jiawang District People's Hospital,Xuzhou City,Xuzhou 221011,Jiangsu,China)

机构地区：[1]徐州市贾汪区人民医院麻醉科,江苏徐州221011

出　　处：《系统医学》2025年第4期153-156,共4页Systems Medicine

摘　　要：目的研究剖宫产术中应用不同剂量甲氧明的临床效果。方法非随机选取徐州市贾汪区人民医院于2022年3月—2023年6月收治的120例剖宫产产妇为观察对象,所有产妇均应用腰硬联合麻醉,按麻醉方案差异分为3组,每组40例。1 mg组产妇于蛛网膜下隙给药后使用1 mg盐酸甲氧明,2 mg组产妇使用2 mg盐酸甲氧明,对照组则注射2 mL生理盐水。比较3组产妇的收缩压与心率、不良反应发生情况,以及新生儿的血气指标及Apgar评分。结果3组产妇T0~T2时间点的收缩压、心率水平比较,差异无统计学意义(P均>0.05)。1 mg组、2 mg组产妇T3~T4时间点的收缩压高于对照组,心率低于对照组,差异有统计学意义(P均<0.05)。3组新生儿血气指标以及Apgar评分比较,差异无统计学意义(P均>0.05)。1 mg组产妇的不良反应发生率为2.50%(1/40),低于对照组的25.00%(10/40)及2 mg组的20.00%(8/40),3组不良反应发生率比较,差异有统计学意义(χ^(2)=8.233,P<0.05)。结论在剖宫产术中应用1 mg或2 mg甲氧明均可有效稳定产妇的血流动力学指标水平,且对新生儿的影响较小,1 mg剂量的安全性更高。Objective To study the clinical effect of different doses of methoxyamine in cesarean section.Methods A total of 120 puerpera who had cesarean section in Jiawang District People's Hospital of Xuzhou City from March 2022 to June 2023 were non-randomly selected as the subjects.All puerpera received combined epidural and lumbar anesthesia,and were divided into three groups according to the difference of anesthesia plan,with 40 cases in each group.Puerpera in the 1 mg group were given 1 mg methoxyamine hydrochloride in the subarachnoid space,the puerpera in the 2 mg group were given 2 mg methoxyamine hydrochloride,and the control group was given 2 mL normal saline.Systolic blood pressure,heart rate,adverse reactions,blood gas index and Apgar score of newborn were compared among the three groups.Results There was no significant difference in systolic blood pressure and heart rate at T0~T2 between the three groups(all P>0.05).Compared with the control group,the systolic blood pressure at T3~T4 time point in 1 mg group and 2 mg group was higher,and the heart rate was lower,the difference was statistically significant(all P<0.05).There was no significant difference in blood gas index and Apgar score among the three groups(all P>0.05).The incidence of adverse reactions in the 1 mg group was 2.50%(1/40),which was lower than 25.00%(10/40)in the control group and 20.00%(8/40)in the 2 mg group,and the difference was statistically significant among the three groups(χ^(2)=8.233,P<0.05).Conclusion The use of 1 mg or 2 mg methoxyamine in cesarean section can effectively stabilize the level of maternal hemodynamic indexes,and the effect on the newborn is small,and the safety of 1 mg is higher.

关 键 词：剖宫产 椎管内麻醉 甲氧明 血流动力学 

分 类 号：R719[医药卫生—妇产科学]