子痫前期产妇行腰麻剖宫产时低血压发生率的研究
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(Correspondingauthor),E?mail:jasmine1982@163.com

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R614.3

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苏州市科技计划项目(SLT201909)


A study on the incidence of hypotension in preeclamptic parturients during cesarean section under lumbar anesthesia
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    摘要:

    目的:观察子痫前期产妇行腰麻剖宫产时低血压的发生率。方法:选择择期腰麻下行子宫下段剖宫产手术的产妇共100例,分为子痫前期组(SE组)和正常产妇组(H组),每组50例。腰麻穿刺成功后,蛛网膜下腔注射0.75%罗哌卡因1.5 mL 加入 10 μg 芬太尼。记录产妇麻醉前(T0)、麻醉后 3 min(T1)、6 min(T2)、9 min(T3)、12 min(T4)、15 min(T5)、胎儿娩出时 (T6)、胎儿娩出后5 min(T7)、手术结束时(T8)的收缩压、舒张压、平均动脉压和心率;记录麻黄碱和去氧肾上腺素的使用量。 结果:SE组产妇麻醉后低血压的发生率为20%,明显低于H组(P < 0.05),且在T1~T4时间点平均动脉压下降的百分比也低于 H组(P < 0.05);SE组麻黄碱的使用量低于H组[(3.5±1.8)mg vs.(8.5±2.6)mg,P < 0.05]。结论:子痫前期产妇在使用低剂量局麻药物复合阿片类药物进行腰麻剖宫产时低血压的发生率低于健康足月产剖宫产的产妇;加强麻醉管理,腰麻可安全用于子痫前期产妇。

    Abstract:

    Objective:To observe the incidence of hypotension in women with preeclampsia undergoing lumbar anesthesia cesarean. Methods:A total of 100 pregnant women undergoing elective cesarean section under spinal anesthesia were divided into SE group (preeclampsia group)and H group(normal parturient group),50 cases in each group. After successful lumbar anesthesia puncture, 1.5 mL 0.75% ropivacaine and fentanyl mixture was injected into subarachnoid sapce;SBP,DBP,MAP and HR were recorded before anesthesia(T0),3 min(T1),6 min(T2),9 min(T3),12 min(T4),and 15 min(T5)after anesthesia,at delivery(T6),5 min after delivery(T7)and at the end of operation(T8). The total amount of ephedrine and phenylephrine used during operation were recorded. Results:The incidence of hypotension was 20% in SE group,lower than that in H group(50%)(P < 0.05). The percentage of MAP decrease at T1~T4 time point was significantly lower than that in H group(P < 0.05). The usage of ephedrine in SE group was lower than that in H group(3.5±1.8)mg vs.(8.5±2.6)mg(P < 0.05). Conclusion:The incidence of hypotension in women with preeclampsia undergoing lumbar anesthesia cesarean section with low dose local anesthesia combined with opioids is lower than that of healthy women with full ? term cesarean section. Enhance anesthesia management,lumbar anesthesia can be used safely for preeclampsia parturient.

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钱菊,彭艳.子痫前期产妇行腰麻剖宫产时低血压发生率的研究[J].南京医科大学学报,2022,(7):1007~1011

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  • 在线发布日期: 2022-07-15
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