摘要
目的探讨甲氧明持续静脉泵入防治剖宫产腰硬联合麻醉低血压的临床效果。方法选择我院2016年3月～2018年2月收治的80例腰硬联合麻醉下实施剖宫产产妇作为研究对象,按照随机数字表法将其分为观察组(40例)与对照组(40例)。对照组在麻醉完成后,即刻静脉注射甲氧明2 mg,如仍存在低血压,则可重复追加甲氧明1～2 mg;观察组持续静脉泵入甲氧明150～300μg/min,直至胎儿娩出。比较两组干预前(麻醉前)及干预后(麻醉后)15 min产妇的动脉压,计算两组胎儿娩出过程中(出生时、出生后1 min及出生后5 min)的新生儿Apgar评分,统计两组产妇出现的相关并发症(术中低血压、恶心呕吐、胸闷头晕)。结果两组干预前的动脉压比较,差异无统计学意义(P>0.05);两组干预后的动脉压显著低于干预前,差异有统计学意义(P<0.05);观察组干预后的动脉压显著高于对照组,差异有统计学意义(P<0.05)。胎儿娩出过程中,出生时、出生后1 min及出生后5 min,观察组的Apgar评分均显著高于对照组,差异有统计学意义(P<0.05)。观察组的并发症总发生率显著低于对照组,差异有统计学意义(P<0.05)。结论针对剖宫产产妇,麻醉后实施静脉持续泵入甲氧明,能有效维持患者血压稳定,提高新生儿出生安全性,减少产妇围术期并发症。
Objective To investigate the clinical effect of continuous intravenous infusion of Methoxamine in the prevention and treatment of low blood pressure combined with spinal and epidural anesthesia for cesarean section.Methods A total of 80 cases with cesarean section who underwent combined spinal and epidural anesthesia from March 2016 to February 2018 in our hospital were divided into the observation group(40 cases)and the control group(40 cases)according to the random number table method.The control group was given an intravenous injection of 2 mg with Methoxamine,if there was still hypotension,Methoxamine 1-2 mg may be added repeatedly.The observation group was used intravenously inject Methoxamine 150-300μg/min until the fetuses were delivered.Then the arterial pressure was compared before the intervention(before anesthesia)and after the intervention(after anesthesia)for 15 min.The Apgar scores of the newborns during the delivery of the fetuses(at birth,1 minute after birth and 5 minutes after birth)were calculated.The complications(intraoperative hypotension,nausea and vomiting,chest tightness and dizziness)in the two groups were counted.Results There was no significant difference in arterial pressure between the two groups before intervention(P>0.05).The arterial pressure after intervention in two groups was significantly lower than that before intervention,and the difference was statistically significant(P<0.05).The arterial pressure after intervention in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).During the delivery of the fetus,at birth and after birth,at 1 minute and 5 minutes after birth,the Apgar scores of the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion For cesarean section women,continuous intravenous infusion of Methoxamine after anesthesia can effectively maintain the patients′blood pressure stability,improve neonatal birth safety,and reduce perioperative complications.
作者
陆双喜
LU Shuang-xi(Department of Anesthesiology,Hospital of Traditional Chinese Medicine of Yingtan City in Jiangxi Province,Yingtan335000,China)
出处
《中国当代医药》
2018年第34期32-34,共3页
China Modern Medicine
基金
江西省鹰潭市科技计划项目([2106]ZC-61-60)
关键词
甲氧明
持续静脉泵入
剖宫产
腰麻
低血压
Methoxamine
Continuous intravenous pumping
Cesarean section
Spinal anesthesia
Hypotension
