摘要
早期的动物实验表明麻黄碱相对α肾上腺素受体激动剂而言极少引起子宫胎盘血流减少,因此一直是产科麻醉首选的升压药,然而近年来的研究提示,对苯肾上腺素等α受体激动剂引起子宫胎盘血管收缩的顾虑被夸大了。麻黄碱可引起产妇心动过速,并且由于代谢兴奋作用能引起胎儿血pH和碱剩余降低,而苯肾上腺素处理脊麻后低血压更加有效且容易滴定,没有发现引起胎儿酸血症的报道。尽管在这一领域还需要进一步的研究,但目前的证据似乎提示苯肾上腺素才是更符合产科需要的升压药。
Historically, ephedrine has been recommended as the best vasopressor in obstetrics because animal studies showed it caused less reduction in uterine blood flow compared with α-agonists. However, recent evidence from clinical trials suggests that concerns about uteroplacental vasoconstriction caused by phenylephrine and other α-agonists are exaggerated. Ephedrine may cause maternal tachycardia and depresses fetal pH and base excess because of its stimulating metabolism. Whereas ad- vantages of phenylephrine include high efficacy for treating and preventing hypotension, easy of titration and no report for its causing fetal acidosis. Although further work is still required in this area, when currently available evidence is taken into account, phenylephrine is the vasopressor that most closely meets the criteria for the best vasopressor to use in obstetric patients.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2008年第3期464-467,共4页
Fudan University Journal of Medical Sciences
关键词
升压药
产科
麻黄碱
苯肾上腺素
低血压
vasopressor
obstetric
ephedrine
phenylephrine
hypotension
