摘要
目的 探讨预防性泵注甲氧明对椎管内麻醉剖宫产孕妇血液流变学及胎儿血气指标的影响。方法 选取2022年1月至2023年3月安阳市第六人民医院收治的180例椎管内麻醉剖宫产孕妇为研究对象,按照随机数字表法分为研究组(90例)和对照组(90例),研究组麻醉穿刺后预防性泵注4 mg甲氧明,术中出现低血压时以1 mg甲氧明静脉注射;对照组不预防性泵注甲氧明,术中甲氧明给药方法同研究组。比较两组产妇血液流变学指标、血流动力学指标及胎儿脐动脉血气指标变化,统计新生儿出生1、5 min Apgar评分及产妇不良反应发生情况、术中甲氧明追加情况。结果 术后,研究组血浆黏度、全血还原黏度、纤维蛋白原水平低于对照组(P<0.05);麻醉后5 min(T_(1))、麻醉后10 min(T_(2))时,研究组心率低于对照组,胎儿娩出时(T_(3))时心率高于对照组(P<0.05);T_(1)~T_(3)时,研究组平均动脉压高于对照组(P<0.05);两组胎儿脐动脉血氧分压、二氧化碳分压、pH值及新生儿出生1、5 min Apgar评分比较,差异无统计学意义(P>0.05);研究组不良反应发生率低于对照组(P<0.05);研究组甲氧明追加率低于对照组(P<0.05)。结论 椎管内麻醉剖宫产产妇中预防性泵注甲氧明可维持其血流动力学稳定,改善血液流变学,降低不良反应发生率、甲氧明追加率,且对胎儿脐动脉血气指标、新生儿Apgar评分无不良影响。
Objective To investigate the effect of prophylactic pumping methoxamine on hemorheology and fetal blood gas in pregnant women undergoing cesarean section under intraspinal anesthesia.Methods A total of 180 pregnant women undergoing spinal anesthesia cesarean section admitted to the Sixth People’s Hospital of Anyang City from January 2022 to March 2023 were selected as the research subjects.They were randomly divided into a study group(90 cases)and a control group(90 cases)according to a random number table method.The study group received prophylactic infusion of 4 mg methoxamine after anesthesia puncture,and 1 mg methoxamine was intravenously injected when hypotension occurred during surgery;The control group did not receive prophylactic infusion of methoxamine,and the method of administering methoxamine during surgery was the same as that of the study group.The changes of hemorheology index,hemodynamic index and fetal umbilical artery blood gas index of the two groups of puerpera were compared,and the Apgar score of the newborn at 1 min and 5 min,the incidence of maternal adverse reactions,and the addition of methoxamine during the operation were counted.Results After surgery,the plasma viscosity,whole blood reduced viscosity,and fibrinogen levels in the study group were lower than those in the control group(P<0.05).At 5 minutes(T_(1))and 10 minutes(T_(2))after anesthesia,the heart rate of the study group was lower than that of the control group,while the heart rate at delivery(T 3)was higher than that of the control group(P<0.05).At T_(1) to T_(3),the average arterial pressure in the study group was higher than that in the control group(P<0.05).There was no significant difference between the two groups in blood oxygen partial pressure,carbon dioxide partial pressure,pH value of fetal umbilical artery and Apgar score at 1 min and 5 min after birth(P>0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).The additional rate of methoxamine in the study group was lower than that in the control group(P<0.05).Conclusion Prophylactic pumping of methoxamine in cesarean section parturients under spinal anesthesia can maintain their hemodynamic stability,improve hemorheology,reduce the incidence of adverse reactions and the rate of addition of methoxamine,and has no adverse effect on fetal umbilical artery blood gas indicators and neonatal Apgar score.
作者
王红旭
王红丽
路玉霞
WANG Hongxu;WANG Hongli;LU Yuxia(Department of Anesthesiology,the Sixth People’s Hospital of Anyang City,Anyang 455000,China;Physical Examination Center,Anyang People’s Hospital,Anyang 455000,China;Department of Otolaryngology,Anyang People’s Hospital,Anyang 455000,China)
出处
《河南医学研究》
2025年第22期4138-4142,共5页
Henan Medical Research
关键词
剖宫产
椎管内麻醉
甲氧明
血液流变学
血气指标
cesarean section
intraspinal anesthesia
methoxamine
hemorheology
blood gas indicators
