对比剖宫产术麻醉前三种药物预扩容的临床效果

Clinical effect of pre-expansion for three injections before anesthesia in cesarean section

目的比较三种注射液高渗氯化钠羟乙基淀粉40、聚明胶肽、0.9%生理盐水用于腰硬联合麻醉前预扩容对60例剖宫产术患者心率、平均动脉压、血氧饱和度的影响。方法将60例患者随机分成三组,每组20例。Ⅰ组输入高渗氯化钠羟乙基淀粉40溶液;Ⅱ组输入聚明胶肽溶液;Ⅲ组输入0.9%生理盐水。均在麻醉前30～45 min内按8 mg/kg输注。监测患者入室时、麻醉前、麻醉后(5、10、15 min)、病房交接班时的HR、MBP、SpO2的变化。结果与入室时基础值比较aP<0.05,bP<0.01;与Ⅰ组比较cP<0.05,dP<0.01,差异有统计学意义。结论羟乙基淀粉预扩容,能较好地维持血流动力学稳定,能有效改善腰硬联合麻醉后的低血压。

Objective To compare the effect of three injection of hypertonic sodium chloride hydroxyethyl starch 40, polygeline injection, 0.9% saline for combined spinal-epidural anesthesia before preload on 60 cases of cesarean section for patients with heart rate, mean arterial pressure, saturation of blood oxygen. Methods 60 patients were randomly divided into three groups, 20 cases in each group. Group Ⅰ input of hypertonic sodium chloride hydroxyethyl starch 40 solution; group Ⅱ inpu polygeline injection solution; group Ⅲ input 0.9% saline. In 30 to 45 minutes before anesthesia by 8mg/kg infusion. Monitoring of patients before, before anesthesia, after anesthesia （5,10, 15 minutes）, ward shift when the HR, MBP, SpO2 changes. Results when a base value comparison of P〈0.05, bP〈0.01; compared with group Icp〈 0.05, aP〈0.01, the difference was statistically significant. Conclusion Hydroxyethyl starch preload, better able to maintain hemodynamic stability, can effectively improve hypotension after lumbar-epidural combined anesthesia.