腰-硬联合麻醉下琥珀酰明胶行急性高容量血液稀释对剖宫产术中患者血流动力学及心肌钙蛋白影响的研究

Effects of Acute Hypervolemic Hemodilution with Succinyl Gelatin Under Combined Spinal-epidural Anesthesia on Hemodynamics and Cardiac Troponin During Cesarean Section

目的探析腰-硬联合麻醉下琥珀酰明胶行急性高容量血液稀释对剖宫产术中患者血流动力学及心肌钙蛋白影响。方法选取2018年3月至2019年3月于吉林大学第一医院麻醉科进行剖宫产的产妇100例,根据随机数字法分为对照组和观察组,各50例。两组产妇均采取腰硬联合麻醉,对照组进行乳酸钠林格试液输注,观察组患者则行4%琥珀酰明胶输注。对比两组患者麻醉前、切皮前以及术后不同阶段的心率、血压、血细胞比容等指标水平。结果观察组患者手术时间等相关治疗显著低于对照组;切皮前及术后观察组患者心率水平显著低于对照组;对照组患者切皮前以及术后血细胞比容高于对照组,且血清肌钙蛋白以及肌酸激酶的指标水平显著低于对照组(P<0.05)。结论在体外循环预充中按照一定剂量及速度输注琥珀酰明胶,可有效增加机体有效循环血容量,维持产妇循环功能。

Objective To investigate the effect of acute high-volume hemodynamics and cardiac calcium protein in patients undergoing Caesarean section by combined waist and hard anaesthesia with succinyl gelatin.Methods A total of 100 cases of women undergoing cesarean section from March 2018 to March 2019 were selected as experimental subjects,and divided into control group and observation group according to random number method,50 cases each.Both groups received combined spinal and epidural anesthesia,the control group received sodium lactate Ringer test solution infusion,and the observation group received 4%succinyl gelatin infusion.The indexes of heart rate,blood pressure and hematocrit were compared between the two groups before anesthesia,before skin incision and at different stages after operation.Results The time of operation and other related treatment were significantly lower than that of control group;Heart rate levels were significantly lower in the precutaneous and postoperative observation group than in the control group;In the control group,the ratio of blood cells was higher than that of the control group before and after resection,and the levels of serum troponin and creatine kinase were significantly lower than those of the control group(P<0.05).Conclusion Injecting succinyl gelatin at a certain dose and speed in precharge of extracorporeal circulation can effectively increase the blood circulation capacity of the body and maintain the maternal circulation function.