格拉司琼联合长托宁防治术中欣母沛不良反应的临床观察

Clinical study on granisetron hydrochloride plus penehyclidine hydrochloride in prevention of adverse reactions of hemabate in cesarean section

目的观察格拉司琼联合长托宁对剖宫产术中欣母沛不良反应的防治效果。方法选择80例存在宫缩乏力出血倾向,需宫体注射欣母沛的剖宫产患者,随机均分为四组(n=20):A组在使用欣母沛前5 min静注格拉司琼3 mg和长托宁0.5 mg;G组在使用欣母沛前5 min静注格拉司琼3 mg;P组在使用欣母沛前5 min静注长托宁0.5 mg(以上均以生理盐水稀释至10 ml);C组为对照组,在使用欣母沛前5 min静注生理盐水10 ml。持续监测四组产妇的心率(HR)、无创血压(NIBP)、呼吸频率(RR)、脉搏血氧饱和度(SpO2),记录术中失血量、输液量、手术时间以及宫体注射欣母沛后的不良反应发生情况。结果 C组产妇恶心、呕吐及面部潮红、心悸胸闷、上腹痛等不良反应的发生率明显高于其余三组,A组发生不良反应的情况较P组及G组更低。宫体注药后C组、G组、P组三组产妇血压、心率均有升高,C组及G组呼吸频率均升高,SpO2均有下降,其中C组变化最为明显,而A组宫体注药前后生命体征差异无统计学意义。结论格拉司琼联合长托宁可以更有效地减少术中欣母沛不良反应的发生,且术中循环呼吸更稳定。

Objective To observe the preventive effect of granisetron hydrochloride plus penehyclidine hydrochloride on adverse reac- tions of hemabate in cesarean section. Methods Eighty pregnant women with high hemorrhagic risk of uterine atony who were per- formed cesarean section and needed to use hemabate were enrolled in this study and were randomly divided into four equal groups. Pa- tients in A group intravenously received granisetron hydroehloride 3 mg and penehyclidine hydrochloride 0.5 mg 5 min before hemabate was injected into uterine muscle ,while patients received intravenously granisetron hydrochloride 3 mg in G group, penehyclidine hydro- chloride 0.5 mg in P group and saline 10 ml in control group. Noninvasive blood pressure, heart rate, respiratory rate, pulse oxygen satu- ration were monitored continuously, and blood loss, transfusion volume, surgical duration and the adverse reactions of hemebate were also recorded. Results The incidences of nausea, vomiting, facial flushing, palpitation, chest distress, epigastric pain were significantly lower in the other three groups than in control group, and the incidence of adverse reactions was lower in A group than in G group and P group. After hemabate was injected into the uterine, BP and HR increased in control group, G group and P group, while SpO2 de- creased and RR rised in control group and G group, especially in control group. In A group, there was no significant changes in all these vital signs before and after injection of hemabate. Conclusion Granisetron hydrochloride plus penehyclidine hydrochloride could ef- fectively reduce the adverse reactions and provide a stable hemodynamic status without respiratory depression.