麻黄碱和甲氧明在治疗剖宫产腰麻低血压中的效果比较

Preventive Effect of Ephedrine and Methoxamine on Spinal Anesthesia-Associated Hypotension in Patients Cesarean Section

【目的】探讨比较麻黄碱和甲氧明在治疗剖宫产腰麻中出现低血压的临床疗效。【方法】对本院妇产科60例进行腰麻时出现低血压的剖宫产产妇的临床资料进行回顾性研究,60产妇按照处理方案不同分为A组(n=30),低血压时给予麻黄碱10mg静注;B组(n=30)低血压时给予甲氧明2mg静注。比较两组产妇血压(EP)和心率(HR)、新生儿Apger评分,胎儿脐动脉血气数值等指标的变化及不良反应。【结果】两组产妇麻醉前和麻醉后15min内收缩压相比较差异无显著性(P>0.05),A组产妇麻醉后6min心率显著高于13组产妇,且差异有显著性(PV0.05)。A组产妇胎儿脐动脉血酸碱度(pH);血氧分压(PaQ);血二氧化碳分压(PaCO2)均低于B组产妇,且两组之间pH值相比较差异具有显著性(P<0.05)。A组低血压发生率低于B组,但差异无显著性(P>0.05),A组心动过缓发生率高于B组,且差异有显著性(P<0.05)。【结论】麻黄碱和甲氧明均有升高剖宫产腰麻低血压的作用,且效果显著,产妇均无严重不良反应,但甲氧明对心率控制更稳定,临床上可推广使用。

【Objective】To compare the clinical efficacy of ephedrine and methoxamine in the treatment of spinal anesthesia-associated hypotension under cesarean section.【Methods】A retrospective study was conducted on the clinical data of 60 patients with cesarean section who had hypotension during spinal anesthesia,including group A(n=30,10 mg ephedrine intravenously)and group B(n=30,2 mg methoxamine intravenously)according to the treatment plans.The changes of maternal blood pressure(BP),heart rate(HR),fetal umbilical arterial blood gas and adverse reactions were compared.【Results】There was no significant difference in systolic blood pressure between the two groups 15 minutes before and after anesthesia(P>0.05).The heart rate of group A was significantly higher than that of group B after 6 minutes of anesthesia(P V0.05).The umbilical arterial blood pH,PaO2 and PaCO2 in group A were lower than those in group B,and the difference in pH value between the two groups was significant(P<0.05).The hypotension of group A was lower than that of group B.However,it didn't show statistical significance(P>0.05).The incidence of bradycardia in group A was more than that in group B(P<0.05).【Conclusion】Both ephedrine and methoxamine can increase spinal anesthesia-associated hypotension under cesarean section with accurate effect.There is no serious adverse reaction in the maternal.Heart rate control by methoxamine is more stable and can be promoted clinically.