不同药物对剖宫产产妇低血压预防效果的对比

Comparison of the Prophylactic Effect of Different Drugs on Cesarean Section Hypotension

目的:探究不同药物对剖宫产产妇低血压的预防效果。方法:选取2014年1月到2014年12月在我院进行剖宫产的80例产妇作为研究对象,按照随机数表法分为三组:麻黄素组、多巴胺组和去氧肾上腺组,在麻醉后,观察不同用药母体低血压的发生率,记录新生儿Apgar评分和产妇入室后5min(T1),麻醉后2min(T2),5min(T3),10min(T4),15min(T5),25min(T6),术毕(T7)共七个时间段的收缩压(SBP)及心率(HR)。结果:麻黄素组低血压的发生率为33.3%,多巴胺组低血压的发生率为24.0%,去氧肾上腺组低血压的发生率为4.0%,三组低血压发生率经比较分析,差异具有统计学意义(P<0.05);三组产妇SBP比较,三组产妇的SBP在7个时间段内差异无统计学意义(p>0.05);三组产妇心率在七个时间段的比较,麻黄素组产妇心率上升,多巴胺组和去氧肾上腺组产妇心率下降。麻黄素组与多巴胺组比较,差异具有统计学意义(P<0.05),多巴胺组和去氧肾上腺组比较,差异无统计学意义(p>0.05)。结论:去氧肾上腺素、多巴胺、麻黄素三种药物都具有稳定产妇血压的作用,但是去氧肾上腺素副作用少,且可以降低心率,较其它两种药物优势更加明显。

Objective： T_o explore the prophylactic effect of different drugs on cesarean section hypotension. Methods： 80 cases of cesarean section from Jan. 2014 to Dec. 2014 in our hospital were selected as the research objects. According to the number table method,they were randomly divided into three groups： ephedrine group,dopamine group and phenylephrine group. After anesthesia,we observed the incidence of hypotension in different drugs uses,recorded Apgar scores in neonates,and systolic blood pressures（ SBP） and heart rates（ HR） in the seven periods,including 5min（ T_1） after entering the maternal room,2min（ T_2）,5min（ T_3）,10min（ T_4）,15min（ T_5）,20min（ T_6） after anesthesia and the postoperative period（ T_7）. Results：The incidence of hypotension in ephedrine group was 33.3%,dopamine group 24.0% and phenylephrine group4.0%. After comparison and analysis,there was significant difference among the incidence of three groups（ P〈0.05）. As for the comparisons of SBP in three groups,the differences were not significant in seven periods（ P〈0.05）. In respect of the heart rates of three groups in these periods,the rate in the ephedrine group increased,but those in dopamine group and phenylephrine group decreased. The difference was significant between ephedrine group and dopamine group（ P〈0. 05）,but not between dopamine group and phenylephrine group（ P〈0.05）. Conclusion： Phenylephrine,dopamine,ephedrine-three drugs play important roles in stabilizing the blood pressures of puerperae,however,phenylephrine has few side effects and reduce the heart rates,which show more obvious advantages than the other two drugs.