不同容量琥珀酰明胶对腰硬联合麻醉下剖宫产患者血流动力学的影响

Effects of different volume gelofusine on hemodynamics in patients undergoing cesarean section with CSEA

目的观察不同容量琥珀酰明胶对腰硬联合麻醉下剖宫产患者血流动力学的影响。方法选择60例剖宫产手术患者,随机分为3组,每组20例。A组:静脉输注琥珀酰明胶250 ml+林格氏液750 ml;B组:静脉输注琥珀酰明胶500 ml+林格氏液500 ml;C组:静脉输注琥珀酰明胶1 000 ml。3组均于麻醉前10 min开始输入琥珀酰明胶,40 min内各输入1 000 ml液体。记录3组麻醉手术期间血压、心率的变化,3组低血压的发生率及不良反应的发生情况。结果 3组SBP在T1、T2、T3与T0相比,均显著下降(P<0.01)。B组、C组SBP在T1、T2高于A组(P<0.05),而且在T3显著高于A组(P<0.01);HR仅A组在T1较T0升高较多(P<0.05)。A组低血压发生率高于B组、C组(P<0.05),均未见异常出血。结论腰硬联合麻醉下剖宫产患者输入500 ml或1 000 ml琥珀酰明胶时,血流动力学更为稳定。

Objective To evaluate the effects of different volume gelofusine on hemodynamies in patients undergoing ce- sarean section with combined spinal and epidural anesthesia （ CSEA ）. Methods Sixty puerperants scheduled for cesarean section were divided into three groups randomly ,20 eases in each group. Croup A received 250ml gelofusine ＋ 750ml Ringerg solution. Group B 500ml gelofusine ＋ 500ml Ringerg solution and Croup C 1000ml gelofusine. All the three groups were given liquid infusion 10 minutes before anesthesia, and received liquid volume 1000ml within 40 minutes. The changes of blood pres- sure and heart rate during operation, tile incidence of hypotension and adverse effects among the ttmee groups were recorded. Results Compared with TO , SBP in T1 , T2 and T3 in all the three groups decreased significantly （ P 〈 0.01 ）. Compared with group A, SBP in T1and T2 in group B and group C was higher （P 〈0.05） and significantly higber in T3（P 〈 0.01 ）. Hypo- tension frequency in group A was higher than that in group B and group C （ P 〈 0.05 ）. No abnormal bleeding was recorded in the three groups. Conclusion When patients undergoing cesarean section with CSEA are infused with 500ml or 1000ml gelo- fusine, hemodvnamics tends to be more steady.