摘要
目的分析不同液体(晶体与胶体)扩容对腰硬联合麻醉下剖宫产患者血流动力学的影响以及安全性。方法纳入该院2018年1—6月收治的剖宫产患者60例,麻醉方法均为腰硬联合麻醉,以“随机数字表法”分组,分研究组(在麻醉前快速输入羟乙基淀酶500 mL,30例)、对照组(在麻醉前快速输入平衡盐溶液500 mL,30例),对比两组麻醉前、麻醉5 min后、麻醉15 min后SBP(收缩压)、DBP(舒张压)、HR(心率)变化情况、不良反应发生率。结果 SBP、DBP、HR麻醉前研究组分别是(126.25±6.25)mmHg、(75.86±3.25)mmHg、(87.28±5.26)次/min;对照组分别是(127.31±6.15)mmHg、(76.01±3.16)mmHg、(87.33±5.21)次/min,SBP、DBP、HR两组麻醉前相比(t=0.662 1、0.181 2、0.037 0 P=0.510 5、0.856 8、0.970 6,P>0.05)。麻醉5 min后研究组分别是(118.26±5.25)mmHg、(68.62±3.05)mmHg、(85.25±4.16)次/min;对照组分别是(105.25±4.05)mmHg、(58.26±1.62)mmHg、(72.25±3.66)次/min,研究组麻醉5 min后显著比对照组高,差异有统计学意义(t=10.756 9、16.430 7、12.850 7,P<0.01)。麻醉15 min后研究组分别是(115.63±4.62)mmHg、(65.25±2.99)mmHg、(84.33±3.26)次/min;对照组分别是(95.25±2.14)mmHg、(55.32±1.54)mmHg、(73.25±1.54)次/min,研究组麻醉15 min后显著比对照组高,差异有统计学意义(t=21.923 7、16.171 3、16.832 2,P<0.01)。研究组不良反应发生率(6.67%)显著比对照组(30.00%)低,差异有统计学意义(χ^2=5.454 5 P=0.019 5,P<0.05)。结论剖宫产患者在麻醉前快速输入羟乙基淀酶500 mL,可维持患者术中血流动力学指标(血压、心率)稳定,且不良反应较少,安全可靠,值得借鉴。
Objective To analyze the effects of different liquid (crystal and colloidal) expansion on hemodynamics and safety of patients undergoing cesarean section under combined spinal and epidural anesthesia. Methods Sixty patients with cesarean section admitted to our hospital from January to June 2018 were enrolled in this study. The anesthesia methods were combined with lumbar and spinal anesthesia. The patients were divided into groups by randomized digital method: the study group (quickly input hydroxyethyl dianase 500 mL, 30 cases before anesthesia), control group (quickly input balanced salt solution 500 mL, 30 cases before anesthesia), compare SBP (systolic blood pressure), DBP (diastolic blood pressure) before anesthesia, 5 minutes after anesthesia, 15 minutes after anesthesia), HR (heart rate) changes, incidence of adverse reactions. Results The pre-anesthesia study groups of SBP, DBP and HR were (126.25±6.25) mmHg,(75.86±3.25) mmHg,(87.28±5.26) times/min, respectively;the control group were (127.31±6.15) mmHg,(76.01±3.16) mmHg,(87.33±5.21) times/min, SBP, DBP, HR were compared with before anesthesia (t=0.662 1, 0.181 2, 0.037 0, P=0.510 5, 0.856 8, 0.970 6, P>0.05). After 5 minutes of anesthesia, the study group was (118.26±5.25) mmHg,(68.62±3.05) mmHg,(85.25±4.16) times/min;the control group was (105.25±4.05) mmHg,(58.26±1.62) mmHg,(72.25 ±3.66) times/min, the study group was significantly higher than the control group after 5 minutes of anesthesia,the difference was statistically significant(t=10.756 9, 16.430 7, 12.850 7, P<0.01). After 15 minutes of anesthesia, the study group was(115.63±4.62)mmHg,(65.25±2.99) mmHg,(84.33±3.26) times/min;the control group was (95.25±2.14) mmHg,(55.32±1.54)mmHg,(73.25±1.54)times/min, the study group was significantly higher than the control group after 15 minutes of anesthesia,the difference was statistically significant(t=21.923 7, 16.171 3, 16.832 2, P<0.01). The incidence of adverse reactions in the study group (6.67%) was significantly lower than that in the control group (30.00%),the difference was statistically significant(χ^2=5.454 5, P=0.019 5). Conclusion Catheterization of patients with hydroxyethylammonase 500 mL before anesthesia can maintain the patient's intraoperative hemodynamic parameters (blood pressure, heart rate) is stable, and fewer adverse reactions, safe and reliable, it is worth learning.
作者
罗雪红
LUO Xue-hong(Department of Anesthesiology,Xinghua Maternal and Child Health Hospital,Xinghua,Jiangsu Province,225700 China)
出处
《世界复合医学》
2019年第8期54-56,共3页
World Journal of Complex Medicine
关键词
羟乙基淀酶
平衡盐溶液
腰硬联合麻醉
剖宫产
血流动力学
不良反应
Hydroxyethylase
Balanced salt solution
Combined spinal and epidural anesthesia
Cesarean section
Hemodynamics
Adverse reactions
