盐酸甲氧明对腰硬联合麻醉下剖宫产术母婴的影响

Effect of methoxamine hydrochloride on maternal and neonates in cesarean section under combined spinal-epidural anesthesia

目的比较分析甲氧明和麻黄碱对剖宫产产妇低血压治疗有效性和新生儿安全性的影响。方法纳入足月单胎妊娠剖宫产产妇60例,随机分2组:盐酸甲氧明组30例(Ⅰ组),麻黄碱组30例(Ⅱ组)。腰麻后Ⅰ组给予盐酸甲氧明静脉泵入10mL/h,Ⅱ组给予盐酸麻黄碱10mg,对比分析2组产妇的心率、收缩压、舒张压变化情况、不良反应的发生率及新生儿脐动脉血气分析、Apgar评分情况。结果 2组产妇收缩压及舒张压手术前后比较差异无统计学意义(P>0.05),Ⅰ组心率明显低于Ⅱ组,差异有统计学意义(P<0.05);Ⅱ组新生儿脐动脉血pH值、碳酸氢根(HCO3^-)、剩余碱(BE)均低于Ⅰ组(P<0.05);2组新生儿脐动脉血的氧分压(PO_2)、二氧化碳分压(PCO_2)比较,差异均无统计学意义(P>0.05);2组新生儿娩出后1min Apgar评分接近,差异均无统计学意义(P>0.05);5min Apgar评分均为10分。结论盐酸甲氧明和麻黄碱均能有效纠正剖宫产产妇术中出现的低血压症状,前者较后者能更有效地增加胎儿的氧供应,减少由于缺氧引起的酸中毒。

Objective To compare the effect of methoxamine and ephedrine on the efficacy and safety of maternal and neonates in cesarean section.Methods Sixty cases of cesarean section were divided into two groups： 30 cases in group Ⅰ and 30 cases in group Ⅱ （ephedrine group）.Group Ⅰ was given 10 mL/h of methamphetamine intravenously, Group Ⅱ was given 10 mg of ephedrine hydrochloride.The changes of heart rate, systolic blood pressure, diastolic blood pressure, incidence of adverse reactions and neonatal umbilical arterial blood gas analysis, Apgar scores were compared between the two groups.Results There was no significant change in systolic and diastolic blood pressure between the two groups（P〉0.05）.The heart rate of group Ⅰ was significantly lower than that of group Ⅱ, the difference was statistically significant（P〈0.05）.The serum pH value, bicarbonate （HCO3-） and residual alkali （BE） of umbilical artery in group Ⅱ were lower than those in group Ⅰ（P〈0.05）.There were no significant differences in the oxygen partial pressure （PO2） and the partial pressure of carbon dioxide （PCO2） of umbilical artery between the two groups（P＆gt;0.05）.Apgar scores were close to each group after 1 min of neonatal delivery （P＆gt;0.05）,and Apgar scores were 10 after 5 min.Conclusion Methoxamine and ephedrine can effectively correct the symptoms of hypotension in cesarean section;the former can increase the fetal oxygen supply more effectively, and reduce the acidosis caused by hypoxia.