腰麻药剂量对妊高征血栓前状态的影响

Effects of dosage of spinal anesthesia on prethrombus state of pregnancy-induced hypertensive syndrome

目的研究腰麻对妊高征(PHS)血栓前状态的影响。方法确诊为PHS择期剖宫产产妇60例,随机均分为A、B、C三组,分别用布比卡因7、9mg或11mg施行腰麻。另选确诊PHS经阴道分娩产妇20例作对照(D组)。观察手术前后血栓调节蛋白(TM)、D-二聚体(D-D)和血小板因子4(PF4)的变化。结果与术前比较,A、B、C组术后TM、D-D显著下降,PF4显著升高(P<0.05或P<0.01)。术后C组PF4明显高于D组(P<0.01)。结论PHS产妇手术后血栓前状态三项指标呈现显著变化,但腰麻局麻药剂量对其无明显影响。

Objective To observe the effects of dosage of spinal anesthesia on prethrombus state of pregnancyqnduced hypertension symptom（PHS）. Methods Sixty selective cesarean section patients with PHS were randomly divided into three groups with 20 cases each. Spinal anesthesia was performed with bupivacaine in a dose of 7 mg（group A）, 9 mg（group B） or 11 mg（group C）, respectively. Another 20 PHS patients via vaginal delivery（group D） were taken as the controls. D- dimer（D-D）, thrombomodulin（TM） and platelet factor 4 （PF4） were examined before and after operation. Results Compared to those before, TM and I）D were declined, but PF4 increased after operation in groups of A,B and C （P〈0.05 or P〈 0. 01）. PF4 was higher in group C than that in group D after operation（P〈0. 01）. Conclusion The three indicators of prethrombotic state in patients with PHS showes significant changes after operation,on which the dosage of spinal anesthesia has no effect.