摘要
目的探讨硬膜外麻醉及缩宫素对剖宫产患者的循环血液动力学的影响。方法对40例无妊娠合并症,在持续硬膜外麻醉下行剖宫产的患者随机分为A、B两组(n=20),分别于娩出胎儿后A组立即给予催产素10U缓慢静脉注射加催产素20U子宫肌注射,B组催产素20U子宫肌注射,两组均于术后给予米索前列醇25μg纳肛。应用CFD-Ⅱ型心血管功能检诊仪分别于麻醉前、麻醉后、胎儿娩出后及应用缩宫素后监测血液动力学参数。结果两组在硬膜外麻醉后每搏功指数、大循环血容量及平均动脉压均显著下降(分别为P<0.05或P<0.01),娩出胎儿后每搏血量、心输出量、每搏功指数、大循环血容量及平均动脉压均显著下降,总血管阻抗升高(分别P<0.05或P<0.01)。两组血液动力学参数分别于娩出胎儿后(2.1±0.4)min及(3.0±0.6)min回复至基线水平。两组间手术时间及出血量均无显著差异(P>0.05)。结论硬膜外麻醉下剖宫产对患者血液动力学产生显著影响,术中联合应用缩宫素是安全的,并有利于血液动力学变化的迅速恢复。
Objective:To investigate the influence of eqidural anaesthesia and Oxytocin injection on the systemic hemodynamics of pregnant women undergoing Caesarean section.Methods:40healthy pregnant wom-en scheduled for Caesarean section with eqidural anaesthesia were randomized into two equal groups(A and B n=20).Patients in Group A receive10IU oxytocin intravenous injection and20IU intramyometrial injec-tion and Group2patients received20IU imy after infant delivery.All patients received25μg rectal miso-prostol tablet after operation.The following parameters:strode volume(SV);cardiac output(CO);cardiac index(CI);pulse rate(PR);stroke work index(SWI);L.V-ejection fraction(LVEF);systemic vascular resistance(SVR);general circulatory blood volume(GBV)and mean arterial pressure(MAP)were recorded with CFD-Ⅱcardiovascular function detecting and diagnosing equipment before and after eqidural anaesthesia and after in-fant delivery and after oxytocin injection.Results:SWI,GBV and MAP were significantly decreased after e-qidural anaesthesia and SV,CO,SWI,GBV and MAP were all significantly decreased and SVRincreased afterinfant delivery in two groups(P<0.05or P<0.01respectively).The parameters returned to baseline in(2.1±0.4)min in Group A and(3.0±0.6)min in Group B after oxytocin injection.There was no significant difference in postpartum blood loss between two groups(P>0.05).Conclusions:The systemic hemodynamics of women wom-en significantly affected under eqidural anaesthesia for Caesarean section,Route of oxytocin injection was safety and efficacy for the prevention of postpartum hemorrhage and there were benefit for improving the sys-temic hemodynamics returned to normal states.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第7期100-102,共3页
China Journal of Modern Medicine
关键词
硬膜外麻醉
剖宫产
血液动力学
缩宫素
epidural anaesthesia
cesarean section
hemodynamics
oxytocin
