摘要
目的观察地塞米松联合甲氧氯普胺预防卡前列素氨丁三醇术中不良反应的效果。方法选择足月剖宫产术中使用卡前列素氨丁三醇的患者60例,随机分为甲氧氯普胺组和托烷司琼组,各30例。在产妇出现宫缩乏力后,甲氧氯普胺组予地塞米松磷酸钠注射液10 mg+盐酸甲氧氯普胺注射液10 mg,iv;托烷司琼组予地塞米松磷酸钠注射液10 mg+盐酸托烷司琼注射液2 mg,iv。2组产妇均在给药1 min后于子宫体深部予卡前列素氨丁三醇注射液250μg,im。2组患者均在给予卡前列素氨丁三醇前1 min(T_(0))和给药后30 min(T_(1))采集静脉血测定血清中胃动素和促胃液素水平,记录产妇血氧饱和度(SpO_(2))、心率(HR)、收缩压(SBP)、舒张压(DBP)、恶心呕吐以及其他不良反应发生情况。自婴儿娩出开始对婴儿及产妇进行为期96 h的医学观察,记录可能相关的不良反应。结果甲氧氯普胺组Ⅱ~Ⅲ级恶心呕吐发生率低于托烷司琼组(P<0.05)。2组的SpO_(2)、HR保持平稳。T_(1)时,托烷司琼组患者血压较T_(0)时显著降低(P<0.05);而甲氧氯普胺组血压虽有所下降,但与T0时比较,差异未见统计学意义(P>0.05)。T1时,托烷司琼组产妇的促胃液素和胃动素水平均降低,与同组T_(0)时比较,差异有统计学意义(P<0.05);甲氧氯普胺组产妇的促胃液素和胃动素较同组T_(0)时稍有升高,但差异未见无统计学意义(P>0.05)。娩出婴儿96 h医学观察,未收集到与药物明确相关的不良发应。结论地塞米松联合甲氧氯普胺可以预防卡前列素氨丁三醇术中恶心呕吐的不良反应。
AIM To observe the effect of dexamethasone combined with metoclopramide on the prevention of intraoperative adverse reactions of carboprost tromethamine.METHODS Sixty patients who had used carboprost tromethamine during full-term cesarean section were randomly divided into metoclopramide group and tropisetron group,with 30 patients in each group.After uterine inertia,the parturient women in metoclopramide group were given dexamethasone sodium phosphate injection 10 mg+metoclopramide dihydrochloride injection 10 mg,iv and in tropisetron group were given dexamethasone sodium phosphate injection 10 mg+tropisetron hydrochloride injection 2 mg,iv.Both groups of parturients were given carboprost tromethamine injection 250μg,im,in the deep part of uterus 1 min after administration.Venous blood was collected 1 min(T_(0))before and 30 min(T_(1))after administration of carboprost tromethamine to measure serum motilin and gastrin levels,and the maternal blood oxygen saturation(SpO_(2)),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),nausea and vomiting,and other adverse reactions were recorded.The infants and parturients were observed for 96 h since the delivery of the infants,and the possible related adverse reactions were recorded.RESULTS The incidence of gradeⅡ-Ⅲnausea and vomiting in metoclopramide group was lower than that in tropisetron group(P<0.05).SpO_(2) and HR of 2 groups remained stable.At T1,the blood pressure of the patients in the tropisetron group was significantly lower than that at T0(P<0.05).In the metoclopramide group,the blood pressure decreased,but there was no significant difference compared with T0(P>0.05).The levels of gastrin and motilin decreased in the tropisetron group at T_(1),which was statistically significant compared with the same group at T_(0)(P<0.05).The levels of gastrin and motilin in metoclopramide group were slightly higher than those in the same group at T_(0),but the difference was not statistically significant(P>0.05).After 96 h of medical observation for infants,no drugrelated adverse reactions were collected.CONCLUSION Dexamethasone combined with metoclopramide can prevent the adverse reactions of nausea and vomiting caused by carboprost tromethamine during operation.
作者
任春玲
张海青
李伟
闫美兴
王大志
REN Chunling;ZHANG Haiqing;LI Wei;YAN Meixing;WANG Dazhi(Department of Pharmacy,Qingdao Women and Children's Hospital,Qingdao 266000,China;Anesthesia Center,Qingdao Women and Children's Hospital,Qingdao 266000,China;Department of Clinical Laboratory,Qingdao Women and Children's Hospital,Qingdao 266000,China;Department of Pharmacy,Qingdao Municipal Hospital,Qingdao 266000,China)
出处
《中国临床药学杂志》
CAS
2021年第6期405-408,共4页
Chinese Journal of Clinical Pharmacy
