预防性持续静脉输注去氧肾上腺素预防腰麻剖宫产术缩宫素对产妇血流动力学的影响

Preventive Continuous Intravenous Infusion of Phenylephrine Prevent Effects when Parturient Women were Given Oxytocin for Cesarean Section in Spinal Anesthesia on Maternal Hemodynamics.

目的:探讨去氧肾上腺素预防性静脉输注预防腰麻下剖宫产缩宫素对产妇血流动力学的不良影响。方法:择期在腰麻下行剖宫产术60例,随机分为去氧肾上腺素组(P组)和对照组(C组),每组30例。两组产妇在娩出胎儿后均给予缩宫素10IU静脉注射+10IU(加入0.9%氯化钠注射液100ml)持续静脉点滴。P组产妇在娩出胎儿后静脉注射缩宫素前给予去氧肾上腺素30μg静脉注射,然后在静脉注射缩宫素同时以30～50μg/min去氧肾上腺素(200μg+0.9%氯化钠注射液20ml)微泵静脉持续输注。C组不给予任何预防性血管收缩药。静脉注射缩宫素后如出现严重低血压,P组给予治疗性去氧肾上腺素30～50μg静脉注射,C组给予50～100μg静脉注射。记录产妇SBP、HR变化、低血压、高血压、心动过速、心动过缓和恶心呕吐发生率以及去氧肾上腺素使用情况。结果:静脉注射缩宫素后P组无低血压及心动过速发生,出现高血压2例(6%),无心动过缓发生。C组低血压、心动过速、恶心呕吐发生率及治疗性去氧肾上腺素使用率显著高于P组(P<0.01)。结论:去氧肾上腺素预防性静脉输注能有效预防腰麻下剖宫产术产妇静脉注射缩宫素引起的低血压及心动过速。

This study aims to investigate preventive intravenous infusion of phenylephrine prevent harmful effects when parturient women were given oxytocin intravenously for cesarean section in spinal anesthesia on maternal hemodynamics. Methods： 60 healthy pregnant women scheduled for caesarean section with spinal anesthesia were ran- domized into two equal groups（P and C, n= 30）. Patients in both groups receive 10IU oxytocin intravenous injection and 10 IU （0. 9% sodium chloride injection 100ml） continuous intravenous administration. After infant delivery. Pa- tients in group P （the phenylephrine group）receive 30/1g phenylephrine intravenous injection before the oxytocin re- ceive, and were given 10IU oxytocin intravenous injection, meanwhile, continual infuse of the 30-50μg/min phenyleph- fine （200μg ＋0. 9% sodium chloride injection 20mi） was performed with the infuse pump. Patients in group C（the control group） are not received any preventive vasoconstrictor. If severe hypotension occurr after receive oxytocin intra- venous injection, patients in group P will receive 30-50μg therapeutic phenylephrine intravenous injection and receive 50-100μg in group C. The SBP, changes of heart rate, and the side-effect incidence rate of hypotension, hypertension, tachycardia, bradycardia, and vomiting and the phenylephrine. Using condition were recorded in all parturient women. Results：Patients in group P after the intravenous injection of oxytocin were no hypotension, tachycardia, and bradycardi- a, but hypertension occurred in 2 cases （6 %）. The incidence of hypotension, tachycardia, nausea and vomiting, and the usage rate of treatment of phenylephrine significantly decreased （P〈0. 01） in the control group compared with the phenylephrine group. Conclusion： Hypotension and heartbeat tachycardia, which are induced by intravenous injection of oxytoein for cesarean section in spinal anesthesia can be effectively prevented when treated with preventive intravenous infusion of phenylephrine.