摘要
目的对实施联合阻滞的剖宫产患者进行目标导向液体治疗,以讨论哪种液体对于防治患者围术期低血压更有意义。方法随机选取本院收治的60例择期剖宫产患者(ASAⅠ～Ⅱ)分为胶体组和晶体组,分别采用万汶注射液+乳酸钠林格注射液和单纯乳酸钠林格注射液进行液体治疗,评价产妇低血压的发生率和胎儿娩出前血管活性药物的使用情况以及新生儿血气分析、新生儿Apgar评分和其他不良反应。结果晶体组患者的冲击液体量、液体量及尿量多于胶体组(P <0. 05)。两组患者低血压以及恶心呕吐的发生率比较差异无统计学意义(P> 0. 05)。两组新生儿Apgar评分及脐动脉血气分析结果差异无统计学意义(P> 0. 05)。结论对于行联合阻滞的剖宫产患者实施目标导向液体治疗时,胶体与晶体相比并无优势。
Objective This study will compare crystalloid to colloid for goal-directed fluid therapy (GDFT) in cesarean section under combined spinal epidural anesthesia , and to discuss which type of fluid is more effective to prevent perioperative hypotention. Methods We randomly assigned 60 patients (ASA Ⅰ-Ⅱ) scheduled undergoing cesarean section into two groups: colloid group and crystalloid group. The colloid group received balanced 6% HES (130/0.4, Volulyte) and Lactated Ringer's solution (LR), while the crystalloid group just received LR as haemodynamic optimization fluid. The primary outcomes included the incidence of maternal hypotension, and vasopressor doses prior to delivery. The secondary outcomes included umbilical blood gas abnormalities, neonatal Apgar grade and adverse events. Results The impact fluid volume, total liquid volume and urine volume in the crystalloid group were more than those in the colloid group (P<0.05). No statistical difference was seen in the number of patients who showed hypotension, vomiting and nausea between two groups. And there was no significant difference in the incidence of neonatal adverse effects between two groups. Conclusions No evidence showed that colloid had more advantages in GDFT for patients received cesarean section under combined spinal epidural anesthesia, except that the volume of colloid input was less than crystalloid.
作者
孙楠
于田
徐浩钧
赵平
Sun Nan;Yu Tian;Xu Haojun;Zhao Ping(Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang 110004, China)
出处
《中国医师杂志》
CAS
2018年第12期1829-1832,1836,共5页
Journal of Chinese Physician
