摘要
目的探讨应用麻黄碱纠正腰麻剖宫产术中低血压对脐动脉血气及胎儿的影响。方法选择ASAⅠ或Ⅱ级产妇40例，年龄26～34岁。无妊娠合并症。无胎儿异常，足月单胎妊娠。腰麻后出现低血压（收缩压低于基础值30％）。先快速输入羟乙基淀粉200／0．5500ml，向左侧提起子宫，抬高产妇下肢纠正低血压。3min后，低血压有效纠正者24例（对照组），无效者16例给麻黄碱10mg静推（麻黄碱组，必要时追加麻黄碱10mg）。胎儿娩出尚未出现第一次呼吸之前用两把血管钳钳夹一段脐带，抽取脐动脉血行血气分析。记录注腰麻药即刻至切开子宫时间、子宫切开至胎儿娩出时间、术中产妇心率、恶心呕吐及胎儿出生时的Apgar评分。结果两组注腰麻药即刻至切开子宫时间、子宫切开至胎儿娩出时间、术中产妇心率、恶心呕吐及胎儿出生时Apgar评分差异均无统计学意义。两组脐动脉血PO2、PCO2、pH、碱剩余（BE）差异均无统计学意义。结论适当剂量麻黄碱可安全用于治疗腰麻引起的剖宫产术中低血压，对母体及胎儿无不良影响。
Objective To study the safety of ephedrine for treatment of spinal anesthesiainduced hypotension during Cesarean section. Methods Forty ASA physical status Ⅰ or Ⅱ parturients underwent Cesarean section under spinal anesthesia and had hypotension （SBP decreased for 30% of baseline）. Hypotention was effectively corrected after rapid infusion of colloid fluid , left movement of the uterus and both legs lifting for 3 minutes in 24 cases（group A）, but was not in 16 parturients （group B）. Ephedrine 10 mg was given intravenousely in group B, which was used repeadedly if necessary. Umbilical artery blood was taken before the first time of new-born breath for blood gas analysis. The time intervals from spinal anesthesia to skin incision（T1 ） and from uterine incision to delivery（T2 ）, maternal heart rate, incidence of nausea and vomiting and Apgar score at birth were recorded. Results No statistical significant differences were found in umbilical artery blood-gas analysis and Apgar score between two groups. Conclusion Ephedrine can be safely used for the treatment of spinal anesthesia-induced hypotention during Cesarean section without detrimental effect on umbilical artery blood gas and fetus.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第7期580-582,共3页
Journal of Clinical Anesthesiology
关键词
麻黄碱
剖宫产
腰麻
低血压
Ephedrine
Cesarean section
Spinal anesthesia
Hypotension
