两种不同晶体液预扩容对剖宫产术后炎性反应的影响

目的 研究分析剖宫产术实施两种不同晶体液预扩容对产妇术后炎性反应的影响,探讨最佳的术前扩容方案.方法 选取2014年10月至2015年12月收住本院的择期剖宫产产妇32例为试验组,麻醉前以15 ～ 20ml·kg-1·h-1输入复方醋酸钠预扩容,总量为10 ml/kg.另选取同期入院产妇30例为对照组,给予复方乳酸钠预扩容,用法用量同试验组.分别在术前、手术结束时以及术后24 h检测各组产妇静脉血IL-6、TNF-α和C反应蛋白(CRP)水平并进行分析比较.结果 试验组术后IL-6、TNF-α和CRP分别为(75.4±8.4)ng/L、(15.7±3.2)ng/L和(72.5±8.6)mg/L,而对照组则分别为(57.8±6.8)ng/L、(10.4±2.3) ng/L和(51.4±7.8) mg/L,试验组产妇IL-6、TNF-α和CRP水平显著高于对照组,差异有统计学意义(P＜0.05).但试验组与对照组产妇在术前及术后24 h IL-6、TNF-α和CRP水平比较差异无统计学意义(P＞0.05).结论 复方醋酸钠可促使产妇术后炎性因子释放.

Effect of two kinds of crystalloid solutions volume pre-expansion on inflammatory reaction after cesarean section

Objective To investigate the effect of two kinds ofcrystalloid solutions volume pre-expansion on inflammatory reaction after cesarean section,and explore the best preoperative expansion plan.Methods 32 puerperae undergoing cesarean section were selected as experimental group from October 2014 to December 2015,and l 0 ml/kg of compound sodium acetate was infused for volume pre-expansion before anesthesia (15-20 ml · kg-1 · h-1).30 puerperae at the same period were infused with compound sodium lactate before anesthesia (control group).The levels of IL-6,TNF-α,and CRP of two groups were detected and compared at the pre-operation,the end of the operation,and 24 hours after operation.Results The levels of IL-6,TNF-α,and CRP of the experimental group at the end of the operation were (75.4±8.4)ng/L,(15.7±3.2)ng/L,and (72.5±8.6)mg/L,and those of the control group were (57.8±6.8)ng/L,(10.4±2.3)ng/L,and (51.4±7.8)mg/L,those of the experimental group were significantly higher (P＜0.05).There were no statistically significant differences in the levels of IL-6,TNF-a,and CRP between the experimental group and the control group when transfusion or at 24 hours after operation (P＞0.05).Conclusion Compound sodium acetate can promote the release of inflammatory factors in pregnant women.