腰麻硬膜外联合阻滞麻醉下剖宫产产妇应用去氧肾上腺素的效果观察

Observation of the Effect of Application of Phenylephrine on Parturients with Cesarean Section under Combined Spinal-epidural Anesthesia

目的:探讨腰麻硬膜外联合阻滞麻醉下剖宫产产妇应用去氧肾上腺素的临床效果。方法:此次102例研究对象均自某院收治的剖宫产产妇中进行选取,选例时间为2019年8月~2020年12月,依据随机数字表法将其分为对照组和观察组各51例,对照组给予腰麻硬膜外联合阻滞麻醉及盐酸麻黄碱注射液,观察组给予同对照组相同腰麻硬膜外联合阻滞麻醉方式及盐酸去氧肾上腺素注射液。两组均于产后观察48h,对比两组产妇围术期情况、不同时间段生命体征,新生儿血气指标。结果:两组产妇手术时间与术中净出入量相比均无显著差异(P>0.05);与T~T_(1)时段相比,T~T_(2)时段两组产妇心率差值、心输出量差值均升高,平均动脉压差值则降低(P<0.05),但组间比较均无显著差异(P>0.05);观察组新生儿pH值高于对照组,PaCO_(2)水平低于对照组(P<0.05),两组PaO_(2)水平相比无显著差异(P>0.05)。结论:腰麻硬膜外联合阻滞麻醉下剖宫产产妇应用去氧肾上腺素可更好地维持新生儿机体内的酸碱平衡,辅助稳定产妇机体血流动力学,效果显著。

Objective:To investigate the clinical effect of application of phenylephrine on parturients with cesarean section under combined spinal-epidural anesthesia.Methods:102 cesarean section women in a hospital from August 2019 to December 2020 were selected as study subjects and divided into control group and observation group according to the random number table method,with 51 cases in each group.The control group was given combined spinal-epidural anesthesia and ephedrine hydrochloride injection,and the observation group was given the same method of combined spinal-epidural anesthesia and phenylephrine hydrochloride injection as the control group.Both groups were observed for 48 hours after delivery.The perioperative conditions,vital signs at different time periods,and neonatal blood gas indexes were compared between the two groups.Results:There was no significant difference between the two groups in maternal operation time and intraoperative net input and output(P>0.05).Compared with the T~T_(1) period,the differences in heart rate and cardiac output of the two groups were increased in the T~T_(2) period,the mean arterial pressure difference value was decreased(P<0.05),but there was no significant difference between the two groups(P>0.05).The pH value of newborns in the observation group was higher than that in the control group,and the PaCO_(2) level was lower than that in the control group(P<0.05),there was no significant difference in PaO_(2) level between the two groups(P>0.05).Conclusion:The application of phenylephrine in cesarean parturients under combined spinal-epidural anesthesia can better maintain the acid-base balance in the newborns and help stabilize the hemodynamics of the parturients,which has significant effect.