腰-硬联合麻醉下剖宫产术毕时产妇循环改变的研究

The Change of Postoperative Cesarean Section Women's Circulation of the Blood Combined Spinal-epidural Anesthesia

目的:观察腰硬联合麻醉下剖宫产产妇术毕时循环的特点。方法:腰硬联合麻醉下行剖宫产的产妇320例,入室后输羟乙基淀粉500mL,继以乳酸林格液500mL维持,记录入室后、手术结束前10min、5min、术毕即刻产妇的平均动脉压(MAP)、心率(HR)、心输出量(CO)、血管阻力(SVR)、胸腔液体量(TFC)。结果:手术结束前10min、5min、术毕即刻产妇的MAP、血管阻力与麻醉前比较明显降低(P<0.05),心输出量明显升高(P<0.05),HR、TFC与麻醉前对比无统计学意义。结论:剖宫产手术的患者在围术期血流动力学波动显著,术毕时仍然可能发生明显的低血压,应给予足够的重视。

Objective：This study is to observe the characteristics of postoperative Cesarean Section of women＇s circulation of the blood combined spinal-epidural anesthesia.Methods：We collected 320 cases of Cesarean Section women with combined spinal-epidural anesthesia.After entering the operating room,we took intravenous input with hydrometry starch 500 mL,then maintainedwith Lactated Ringer＇s solution500 mL.We recorded the data of Cesarean Section women＇s mean arterial pressure（MAP）,heart rate（HR）,cardiac output（CO）,vascular resistance（SVR）,and pleural fluid content（TFC）when being preoperative,5 minutes before the end of surgery,10 minutes before the end of surgery and the end of surgery.Results：Cesarean Section women＇s mean arterial pressure（MAP）and vascular resistance（SVR）of 5 minutes before the end of surgery,10 minutes before the end of surgery and the end of surgery than preoperative has significantly decreased（P〈0.05）,while cardiac output（CO）has significantly increased（P〈0.05）,heart rate（HR）,but the cardiac output（CO）,vascular resistance（SVR）,and pleural fluid content（TFC）have no statistical significance.Conclusion：Cesarean Section women have significant fluctuations of hemodynamic at period of operation,which may occur at the end of surgery,therefore,we should pay enough attention.