血安定纠正婴幼儿早期低血容量性休克30例

Thirty Cases of Infant's Early Hypovolemic Shock Corrected with Gelofusine

目的 :了解血安定用于婴幼儿急腹症 ,在麻醉及围术期输液 ,扩充患儿有效血容量、改善微循环等抗休克效果。方法 :选择 3 0例婴幼儿急腹症伴早期低血容性休克 ,需紧急施行“剖腹探查”手术病例 ,麻醉及围术期使用血安定输液 ,同时连续监测心率 (HR)、收缩压 (SBP)、脉压差、中心静脉压 (CVP)、血氧饱合度 (SpO2 )、手指甲床充盈时间、尿量等。结果 :使用血安定静脉输液 15min后 ,SBP回升 ,脉压差增宽 ,SpO2 升高 ,HR减慢 ,手指甲床充盈时间缩短 ,尿量增多 (P<0 .0 5 ) ;3 0min后CVP也升至正常 (P <0 .0 1) ,而且随后各时间段七项指标皆维持平稳向好的趋势。结论 :麻醉及围术期输注血安定 ,能迅速纠正急腹症伴早期低血容量性休克患儿的有效血容量不足 ,改善微循环 ,维持血流动力学稳定 ,为进一步治疗和促进患儿术后恢复创造良好条件。

Objective:To investigate the effect of gelofusine on the early hypovolemic shock in infants with the acute abdomen during perioperation. Method:Tirty infants with acute abdominal disease received infusion of gelofusine under caesarean operaton. The changes of the heart rate (HR), systolic blood pressure (SBP),pulse pressure, central venous pressure (CVP), pulse oxygen saturation value (SpO 2), hyperemia time of finger nail (HTFN), and the uric amount continuously during perioperation were determined. Results:Fifteen minutes after infusion, the data of the SBP, pulse pressure, SpO 2, and the uric amount significantly increased (P<0.05) in all infants, the HR and HTFN decreased obviously (P<0.05),and CVP raised significantly by 30 min at infusion begining 15 min later. Conclusion:The gelofusine could be utilized to rapid correct the symptoms of early hypovolemic shock in infants with the acute abdomen during perioperation, improve the function of microcirculation, keep steady hemodynamics.