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腰麻药剂量对妊高征血栓前状态的影响
引用本文:何虹,龚波,曹爽,唐慧,蔡红霞,王春林,黄唯,陈铭.腰麻药剂量对妊高征血栓前状态的影响[J].临床麻醉学杂志,2009,25(12).
作者姓名:何虹  龚波  曹爽  唐慧  蔡红霞  王春林  黄唯  陈铭
作者单位:1. 上海市长宁区妇幼保健院麻醉科,200051
2. 上海市长宁区妇幼保健院检验科,200051
3. 上海市长宁区妇幼保健院产房,200051
摘    要:目的 研究腰麻对妊高征(PHS)血栓前状态的影响.方法 确诊为PHS择期剖宫产产妇60例,随机均分为A、B、C三组,分别用布比卡因7、9 mg或11 mg施行腰麻.另选确诊PHS经阴道分娩产妇20例作对照(D组).观察手术前后血栓调节蛋白?、D-二聚体(D-D)和血小板因子4(PF4)的变化.结果 与术前比较,A、B、C组术后TM、D-D显著下降,PF4显著升高(P<0.05或P<0.01).术后C组PF4明显高于D组(P<0.01).结论 PHS产妇手术后血栓前状态三项指标呈现显著变化,但腰麻局麻药剂量对其无明显影响.

关 键 词:腰麻  妊娠高血压综合征  血栓调节蛋白  D-二聚体  血小板因子4

Effects of dosage of spinal anesthesia on prethrombus state of pregnancy-induced hypertensive syndrome
Abstract:Objective To observe the effects of dosage of spinal anesthesia on prethrombusstate of pregnancy-induced hypertension symptom(PHS).Methods Sixty selective cesarean sectionpatients with PHS were randomly divided into three groups with 20 cases each.Spinal anesthesia was performed with bupivacaine in a dose of 7 mg(group A),9 mg(group B)or 11 nag(group C),respectively.Another 20 PHS patients via vaginal delivery(group D)were taken as the controls.Ddimer(D-D),thrombomodulin?and platelet factor 4(PF4)were examined before and after operation.Results Compared to those before,TM and D-D were declined,but PF4 increased after operation in groups of A,B and C(P<0.05 or P<0.01).PF4 was higher in group C than that ingrouP D after operation(P<0.01).Conclusion The three indicators of prethrombotic state in patients with PHS showes significant changes after operation,on which the dosage of spinal anesthesia has no effect.
Keywords:Spinal anesthesia  Pregnancy-induced hypertensive syndrom  Thrombomodulin  13-dimer  Platelet factor 4
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