摘要
目的探讨七氟烷、丙泊酚分别联合瑞芬太尼在重度子痫前期孕妇进行剖宫产过程中对血流动力学的影响。方法选取自2014年3月至2016年5月来我院接受治疗的重度子痫前期剖宫产孕妇60例作为研究对象,随机分为七氟烷组(七氟烷联合瑞芬太尼)和丙泊酚组(丙泊酚联合瑞芬太尼),观察两组孕妇在不同时间点的血流动力学特点,术中术后不良反应以及术后镇痛效果。结果丙泊酚组孕妇HR、SV、CO参数在T5时间点、CVP参数在T3-T5时间段显著高于七氟烷组,差异具有统计学意义(P<0.05)。七氟烷组孕妇术中术后不良反应发生率为30.0%显著高于丙泊酚组6.7%,差异有统计学意义(P<0.05)。七氟烷组患者在术后1、15、30和60min时的疼痛评分均显著低于丙泊酚组,差异具有统计学意义(P<0.05)。结论七氟烷和丙泊酚联合瑞芬太尼应用于重度子痫前期孕妇剖宫产手术麻醉均能够取得较好的效果,但七氟烷能够更佳的控制血流动力学改变,但在应用过程中不良反应较多,在实际应用过程中应该注意。
Objective To investigate the effects of sevoflurane and propofol combined with remifentanil on hemodynamics in pregnant women with severe preeclampsia during cesarean section. Methods Sixty pregnant women with severe preeclampsia who had been treated in our hospital from May 3 to May 15, 2015 were selected as subjects. According to random number table, patients were divided into the sevoflurane group （sevoflurane combined with remifentanil） and propofol group （propofol combined with remifentanil）. The hemodynamic characteristics of the two groups were observed at different time points. Postoperative adverse effects and postoperative analgesic effect were compared and analyzed. Results The parameters of HR, SV and CO in the propofol group were significantly higher than those in the sevoflurane group at T3-T5 time points （P〈0.05） at T5 time point, and the difference was statistically significant （P〈0.05）. The occurrence of postoperative adverse reactions was significantly higher in the sevoflurane group （30.0%） than that in the propofol group （6.7%）. The difference was statistically significant （P〈0.05）. The pain scores were significantly lower in the sevoflurane group than those in the propofol group at 1 min, 15 min, 30 min and 60 min after surgery （Z = 5.522, P〈0.05）. Conclusion Sevoflurane and propofol combined with remifentanil can be used in cesarean section anesthesia for severe preectampsia pregnant women. This combination can achieve good results, but sevoflurane can control hemodynamic changes better, but attention should be paid to the adverse reactions in the application process.
出处
《北京医学》
CAS
2017年第4期375-378,共4页
Beijing Medical Journal
