摘要
目的探讨不同靶控输注全身麻醉诱导方案对重度子痫前期剖宫产产妇及新生儿的影响。方法将本院2011年1月至2014年6月拟行全身麻醉剖宫产术的84例重度子痫前期产妇随机分为A、B、C三组,每组各28例。A组产妇靶控输注丙泊酚5μg/ml、瑞芬太尼4 ng/ml,B组产妇靶控输注丙泊酚3.5μg/ml、瑞芬太尼4 ng/ml,C组产妇靶控输注丙泊酚3.5μg/ml、瑞芬太尼3.4 ng/ml;2分钟后行气管插管并开始手术。比较三组产妇麻醉前(T_0)、气管插管即刻(T_1)、切皮后即刻(T_2)、术后拔管时(T_3)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、新生儿剖出时间及新生儿1分钟、5分钟Apgar评分等。结果 T_0、T_1、T_2时刻三组产妇SBP、DBP、MAP、HR比较差异均无显著性(P>0.05),T_3时刻B组产妇SBP、DBP、MAP、HR均显著高于同时间点A、C组产妇(P<0.05),A、C组产妇各血流动力学指标在各时间点比较差异均无显著性(P>0.05)。三组新生儿脐血p H、新生儿剖出时间比较均无显著差异(P>0.05),B组新生儿1分钟Apgar评分低于A、C组(P<0.05),三组新生儿5分钟Apgar评分比较均无显著差异(P>0.05)。结论重度子痫前期产妇行剖宫产术时靶控输注诱导剂量为丙泊酚3.5μg/ml、瑞芬太尼4 ng/ml,对产妇血流动力学干扰可能更小,对新生儿无明显影响。
Objective To investigate the effects of different target controlled infusion of general anesthesia induction program on maternal and neonatal effects of cesarean section in severe preeclampsia. Method84 cases of severe preeclampsia maternal were selected as the research objects in our hospital from January 2011 to June 2014 intends to general anesthesia for cesarean delivery operation, according to the random number table method they were divided into A, B, C groups, 28 cases in each group, three groups of maternal were target controlled infusion of propofol and remifentanil. Maternal in group A were treated with target controlled infusion of propofol 5 μg/ml, remifentanil 4 ng/ml; group B maternal with target controlled infusion of propofol 3.5 μg/ml, remifentanil 4 ng/ml; maternal in group C had a target controlled infusion of propofol 3.5 μg/ml, remifentanil 3.4 ng/ml; after two minutes of tracheal intubation and began the operation. Comparative observation immediately after three groups of maternal before anesthesian（T0）, tracheal intubation（T1）, skin incision（T2）, postoperative extubation（T3）, the SBP and DBP, mean arterial pressure（MAP）, heart rate（HR）, neonatal cesarean section and neonatal 1 minute, 5 minutes Apgar scores. Result There were no significant differences in SBP, DBP, HR, MAP among the three groups at T0, T1 and T2 times（P〉0.05）, at T3 time group B of maternal SBP, DBP, MAP, HR were significantly higher than the same time points of group A, C of maternal（P〈0.05）, there were no significant differences in the hemodynamic parameters of group A and group C at each time point（P〉0.05）. Neonatal umbilical cord blood p H of three groups of maternal, newborn cutting time had no significant differences（P〉0.05）, group B neonatal 1 minute Apgar score were less than group A and group C（P〈0.05）, neonatal 5 minutes Apgar score compared among the three groups had no significant differences（P〉0.05）. Conclusion Severe preeclampsia maternal line during cesarean delivery target controlled infusion induction dose of propofol 3.5 μg/ml, fentanyl 4 ng/ml, to maternal hemodynamic interference may be less, has no obvious effect on neonatal.
出处
《中国医学前沿杂志（电子版）》
2016年第5期61-64,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
唐山市科技局计划项目(14130266B)
关键词
全身麻醉
重度子痫前期
靶控输注
剖宫产术
General anesthesia
Preeclampsia
Target controlled infusion
Cesarean section
