剖宫产术中快速注射缩宫素致血液循环波动的观察

Observation of Fluctuations of Blood Circulation after Intravenous Injection of Oxytocin In Cesarean Section Period

目的：观察剖宫产围手术期静脉注射缩宫素对血压和心率的影响。方法：将90例ASAⅡ~Ⅲ级足月妊娠的产妇随机分为3组。A组30例,应用持续硬膜外麻醉进行剖宫产术,待胎儿取出后静脉注射缩宫素20 U,于注射后的3 min内观察收缩压、舒张压和心率变化;B组30例,用相同麻醉方法进行剖宫产术,术中静脉不用缩宫素,观察指标与方法同A组;C组30例,麻醉方法同前,行剖宫产术,在与A组相同的时间静脉滴注缩宫素,观察指标与方法同A组。结果：A组在注射缩宫素后0.15 min时血压显著下降,心率显著增加,注射后2.5 min时,血压和心率基本恢复到注射前水平。B组和C组无明显血压下降。结论：剖宫产手术时静脉注射常规剂量缩宫素后可致血液循环短暂严重波动,应引起临床妇产科医师高度重视,特别是对心功能储备较差的产妇更应关注。

Objective：To observe cesarean section perioperative blood pressure and heart rate effects after intravenous injection of oxytocin.Methods：90 patients with ASA Ⅱ～Ⅲ grade full-term pregnancy were randomly divided into three groups.30 cases in A group： the application of continuous epidural anesthesia for cesarean section,observed systolic and diastolic blood pressure and heart rate changes,while injected oxytocin 20 U.At 3 min after fetal taken out.30 patients in B group using the same method of cesarean section anesthesia,without oxytocin.30 patients in C group using the same method of cesarean section anesthesia but intravenous infusion of oxytocin.The same as indication were observed.Results：The blood pressure was lower,heart rate increased significantly in A group after injection of 0.15 min.After injection 2.5 min,the blood pressure and heart rate were basically returned to the level before injection.B group and C group had not significantly changed.Conclusion：When cesarean section,conventional-dose intravenous oxytocin have serious short-term fluctuations in blood circulation.Clinical Obstetrics and Gynecology Physicians should have a high degree of attention,especially the patients with poor cardiac function should be more concerned.