摘要
目的:探讨小剂量多巴胺在剖宫产联合麻醉后对产妇仰卧位低血压综合征以及对产妇和胎儿的影响。方法拟择期在联合麻醉下行剖宫产手术的单胎足月妊娠初产妇60例,随机分为两组,A组在脊麻时泵注多巴胺(2 ug/Kg/h)直至胎盘娩出,B组则给予生理盐水泵注至胎盘娩出,硬外置管后快速翻身仰卧位,从注药后2 min开始,每间隔2 min测量生命体征,记录血压,心率和血氧,记录手术中产妇的恶心呕吐,心率失常等不良反应。胎儿娩出后即刻取胎儿脐静脉和动脉血行血气分析。结果 A组产妇术中低血压和恶心呕吐的发生率明显的低于B组(<0.05),A组产妇的收缩压下降幅度明显小于B组。A组产妇的脐带血的PH值明显的高于B组(<0.05)。结论剖宫产的联合麻醉于脊麻开始注药时泵注小剂量多巴胺至胎盘娩出可以明显的减少产妇麻醉后仰卧位低血压综合征和恶心呕吐的发生率,从而可以有效改善脐静脉的酸碱状态,但不影响产妇的舒张压和心率。
Objective To investigate the fetal and maternal ef ect of Infusion low-dose dopamine on sectionsupine hypotensive syndrome for cesarean delivery.Methods Sixty mature panurient women with single-embryo were randomly divived into two groups A and B.Group A patients were pumped with dopamine(2ug/kg/min)from the time spinal anesthesia to delivery of placenta while group B with normal saline.The maternal BP,HR and SPO2 were measured at 2-min intervals beginning 2 min after spinal injection.Immediately after delivery,umbilical arterial and umbilical venous blood samples were withdrawn for the measurement of blood gases.Results The incidence of hypotension and nausea in group A were lower than those in groupB.(<0.05)The decrease of SBP was lower in gro in groupB(<0.05).Conclusion Infusion low-dose dopamine on sectionsupine hypup A(<0.05).The PH values of umbilical venous in group A were higer thanotensive syndrome for cesarean delivery can significantly reduce the drop of maternal systolic blood pressure after spinal anesthesia,reduce the incidence of maternal hypotension and nause,thereby improve the acid-base status of umbilical vein,but does not af ect diastolic blood pressure and heart rate.
作者
王慧娴
李公社
孙焱芫
WANG Hui-xian;LI Gong-she;SUN Yan-yuan(Department of Anesthesiology,Xijing Hospital,Xi'an 710032,Shaanxi,China;Department of Anesthesiology,Shaanxi Maternity and Child Healthy Hospital,Xi'an 710000,Shaanxi,China)
关键词
多巴胺
泵注
仰卧位低血压综合征
剖宫产
Dopamine
pumping-in
supine hypotension syndrome
Cesarean delivery
