鞘内混合芬太尼 罗哌卡因对剖宫产重度子痫前期患者血管内皮损伤相关细胞因子的影响

目的鞘内混合芬太尼、罗哌卡因对剖宫产重度子痫前期患者血管内皮损伤相关细胞因子的影响。方法择期行剖宫产手术的重度子痫前期患者120例，采用随机数字表法分为复合组与对照组。每组各60例，复合组为鞘内注射罗哌卡因＋芬太尼，对照组为鞘内注射罗哌卡因。记录鞘内注射10min后麻醉平面，硬膜外追加利多卡因例数，肌肉松弛评价及副作用低血压、恶心呕吐、头痛、背痛发生率，婴）LApgar评分及脐动脉血pH，检测两组术前术后血浆vWF、GMP-140，COR、NE、PGE水平，比较并分析其相关性。结果两组术后血浆vWF浓度、COIK浓度、NE浓度、PGE浓度比基础值均升高（P〈0．05），复合组NE浓度、PGE浓度比对照组低（P〈0．05）。结论鞘内混合芬太尼、罗哌卡因用于剖宫产术重度子痫前期患者安全可行，可降低手术对患者应激反应及血管损伤，具有一定的临床价值。

Objective To analyze the correlation between blood vessel injury factor and intrathecal fentanyl coadministered with ropivacaine for cesarean delivery under combined spinaI epiduraI in patients with severe preeclampsia. Methods 120 cases of severe preeclampsia patients underwent elective surgery line cesarean section in our hospital were divided into the compound group and control group by random number method. The sensory block level, evaluation of muscle relaxant, Incidence of hypotension, nausea and vomiting, headache, backache, Apgar score and umbilical arterial blood pH were recorded. Detection of two groups of preoperative plasma vWF postoperative, GMP-140, COR, NE, PGE level, their correlations were compared and analyzed. Result The postoperative plasma vWF concentration, concentration of COR, NE concentration and the concentration of PGE called base values of two groups were elevated （P〈0.05） , postoperative NE concentration compound group was lower than those of control group （ P〈0.05 ） , postoperative PGE concentration, compound group was lower than those of control group （P〈0.05 ） . Conclusion Intrathecal fentanyl and ropivacaine are safe and feasible for the patients with severe preeclampsia in caesarean section, which can reduce the stress response and vascular injury of the patients.