摘要
目的观察重度子痫前期患者在全麻或腰硬联合麻醉下行剖宫产时使用缩宫素对血流动力的影响。方法将2010年3月至2010年11月期间需行剖宫产ASAⅡ～Ⅲ级重度子痫前期产妇21例,分为两组,其中G组10例,为存在椎管内麻醉禁忌症而选择全麻组;C组11例,为腰硬联合麻醉组。术中胎儿娩出后即刻宫体注射缩宫素10U,静脉滴注缩宫素10U缓慢维持,观察使用缩宫素2.5min内患者心排出量、每搏量、外周血管阻力、平均动脉压、心率、中心动脉压等变化。结果在缩宫素宫体注射后20s,两组患者的SVR、MAP开始下降、CO、SV增加、HR加快;45～60s达到变化顶峰;缩宫素宫体注射120s后,各血流动力参数大致回到注射前水平。C组血流动力学参数变化波动大于G组。结论重度子痫前期患者在剖宫产术中应用常规剂量缩宫素会导致循环系统迅速短时间内明显的波动,腰硬联合麻醉比全麻波动更明显。
Objective To observe the perioperative hemodynamic effects after the application of oxytocin on patients with severe preeclampsia in spinal-epidural anesthesia or general anesthesia for cesarean section. Methods 21 severe preeclampsia patients, with ASA stage II - III, being consented to an observational study from March 2010 to November 2010, were divided into two groups. 10 cases in group G which existed contraindication in regional anesthesia were given general anesthesia; 10 cases in group C were given spinal-epidural anesthesia for cesarean section. After delivery of the fetus, in both two groups 10 U oxytocin was injected, then 10 U oxytocin was intra- venously injected to maintain slowly. During the application of oxytocin in 2.5 rain, to observe the change of hemodynamics, such as cardiac output, stroke volume, systemic vascular resistance, mean arterial pressure, heart rate, central venous pressure. Results After 20 s in applica- tion of oxytocin, SVR, MAP of both two groups began to decrease, while CO, SV, HR began to increase; in 45 - 60 s, the change ofhemo- dynamics reached the peak; after 120 s, all the hemodynamic values returned to the level before being injected oxytocin. Conclusion The using of conventional-dose oxytocin for patients with severe preeclampsia in perioperative cesarean section can lead to fluctuations of circulatory system in short time, the fluctuations of spinal-epidural anesthesia guoup may be more obvious than that of general anesthesia.
出处
《临床医学工程》
2011年第3期351-353,共3页
Clinical Medicine & Engineering
关键词
缩宫素
重度子痫前期
剖宫产
血流动力
Oxytocin
Severe preeclampsia
Cesarean section
Hemodynamics
