催产素不同使用方法对剖宫产产妇的影响

Efficacy of different use of oxytocin during elective cesarean section

目的:研究催产素不同使用方法对产妇血流动力学影响。方法:160例ASAⅠ～Ⅱ级剖宫产产妇,在取出胎儿后,子宫注射催产素20 U后,分为4组:A组静脉注射催产素20 U;B组静脉注射催产素10 U;C组静脉注射催产素5 U后,持续注射催产素5 U/h 2 h;D组静脉注射催产素2 U后,持续注射催产素10 U/h 2 h。监测心电图(ECG)、无创测量血压(NBP)、血氧饱和度(SpO2)、术中及术后24 h出血量,进行子宫硬度评估,观察用催产素后即刻、10、30、60 min血清中催产素水平,记录恶心、呕吐次数。结果:使用催产素后A、B组平均动脉压(MAP)下降,同时心率变化较大;A组恶心及呕吐发生率较高;A、B、C组催产素水平明显增高,随后下降;组间比较,各组催产素水平依次降低。各组产妇子宫出血量及子宫硬度之间没有显著差异性。结论:剖宫产手术中,小剂量催产素静注加持续输入可以稳定产妇血流动力学及减少催产素相关不良反应。

Objective： To study the efficacy of different use of oxytocin during elective cesarean section. Methods：A total of 160 samples of Anaesthesiologists Ⅰ and Ⅱ subjects undergoing cesarean delivery were randomly divided into four groups. Following fetal extraction, the uterus was injected 20 U oxytocin. Women in the A group received 20 U of oxytocin intravenously within 30 seconds. The B group received 10 U of oxytocin within 30 seconds. The C group received 5 U of oxytocin within 30 seconds followed by an infusion of 5 U/h for 2 hours. The D group received 2 U of oxytocin within 30 seconds followed by an infusion of 10 U/h for 2 hours. We detected ECG,NBP,SpO2, hemodynamics and postoperative vaginal bleeding with 24 hours,uterine contractility, and adverse effects after administration of oxytocin, the serum oxytoein concentration at the beginning of injection, 10,30,60 min. Results： After the administration of oxytocin,the MAP in the A and B groups decreased,but the heart rate increased. The incidence of vomiting and nausea was higher in the group A. The serum oxytocin concentration was significantly increased in the group A, B and C, and then decreased. Compared among groups,the serum oxytocin concentration of the group A,B,C and D were decreased by turns. There was no difference among the groups in the vaginal bleeding volume and the uterine contractility. Conclusion： Low dose of oxytocin followed by an infusion could stable the hemodynamies of women during the elective cesarean section and decreased the adverse effects.