甲氧明对妊娠合并甲亢患者蛛网膜下腔阻滞后低血压的防治效果

Study on Preventive Effects of Methoxamine on Hypotension Following Spinal Anesthesia in Pregnancy Women with Hyperthyroidism

目的:探索甲氧明对妊娠合并甲状腺功能亢进(甲亢)产妇蛛网膜下腔阻滞(脊麻)后低血压的预防作用及对新生儿的影响。方法:妊娠合并甲亢择期剖宫产产妇30例,随机分为C组和M组各15例,脊麻后C组静脉注射生理盐水1ml,M组静脉注射甲氧明2mg。连续测量两组产妇血压和心率,恶心呕吐情况,新生儿娩出时间和输液量,新生儿娩出后抽取脐动脉血测量pH,并在1min和5min进行Apgar评分。结果:两组产妇一般情况、新生儿娩出时间和输液量差异无统计学意义(P>0.05),M组低血压和心动过速发生率均低于C组(P<0.01),但两组恶心呕吐发生率、脐动脉血pH,1min和5min Apgar评分差异无统计学意义(P>0.05)。结论:甲氧明2mg可有效预防妊娠合并甲亢产妇剖宫产脊麻后低血压及心动过速,且对新生儿无不良影响。

Objective： To study the effects of methoxamine on preventing the hypotension following spi- nal anesthesia for cesarean delivery in pregnancy women with hyperthyroidism and on the neonate. Methods： 30 pregnancy women with hyperthyroidism undergoing elective cesarean section were randomly divided into two groups： intravenous injection （ i. v. ） of normal saline （ group C） after spinal anesthesia; and i. v. me- thoxamine 2mg （ group M）. The heart rate and blood pressure of the parturients were monitored continual- ly; nausea and vomiting were recorded; collect umbilical artery for blood gas analysis. Umbilical artery blood pH,Apgar score of 1 rain and 5 min were collected after delivery. Results： The incidence of hypotension and tachycardia of patients in group M was lower than that in group C. Rate of nausea and vomiting, umbilical ar- tery blood pH and Apgar score showed no statistical significance between the two groups. Conclusion： Me- thoxamine is effective in preventing hypotension of parturients with hyperthyroidism undergoing cesarean de- livery, and has no side effect on neonate.