不同剂量右美托咪定对妊高征剖宫产患者血流动力学的影响

目的探讨不同剂量右美托咪定对妊高征剖宫产患者血流动力学的影响。方法将本院行择期剖宫产术的325例妊高征产妇分为对照组与A、B、C、D组,每组各65例产妇。对照组仅接受基础麻醉,A、B、C、D组在基础麻醉的基础上再分别静脉泵入0.1、0.2、0.3、0.4μg/(kg·h)试验量与维持量右美托咪定直至手术结束。分别记录所有产妇硬膜外给药前(T_0)、切皮时(T_1)、胎儿娩出时(T_2)、手术结束时(T_3)的收缩压(SBP)、舒张压(DBP)、心率(HR)等指标。结果 5组4个时间点SBP、DBP、HR相比差异均有统计学意义(P0.05);T_0时,5组的SBP、DBP、HR均显著高于本组T_1、T_2、T_3时(P0.05);T_1时的SBP、DBP、HR均显著高于本组T_2、T_3时(P0.05),其T_2时的SBP、DBP、HR均显著高于本组T_3时(P0.05)。T_0时,5组研究对象SBP、DBP、HR相比差异均无统计学意义(P0.05);T_1~T_3时,5组研究对象SBP、DBP、HR相比差异均有统计学意义(P0.05),D组的SBP、DBP、HR均显著低于A、B、C组,对照组(P0.05),C组的SBP、DBP、HR均显著低于A、B组,对照组(P0.05),B组的SBP、DBP、HR均显著低于A组、对照组(P0.05),A组与对照组之间SBP、DBP、HR相比差异均无统计学意义(P0.05)。结论在妊高征剖宫产术中,右美托咪定剂量为0.4μg/(kg·h)时具有较好的稳定血流动力学作用,且随着剂量的增加,其效果越明显。

Influence of different doses of dexmedetomidine on hemodynamics of pregnancy-induced hypertension syndrome patients with cesarean section

Objective To investigate influence of different doses of dexmedetomidine on hemodynamics of pregnancy-induced hypertension syndrome (PIH) patients with cesarean section.Methods A total of 325 PIH cases in our hospital were divided into control group and A,B,C,D groups,with 65 cases in each group.The control group received only basic anesthesia,A,B,C,D groups were given dexmedetomidine intravenous infusion of 0.1,0.2,0.3,0.4 μg/(kg · h),respectively.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and other indicators before epidural administration (T0),skin incision (T1),fetal delivery (T2),at the end of surgery (T3) were recorded.Results SBP,DBP,HR of 4 time points in 5 groups had a significant difference (P ＜ 0.05).At T0,SBP,DBP and HR of 5 groups were significantly higher than that of T1,T2,T3 (P ＜ 0.05).At T1,SBP,DBP,HR were significantly higher than that of T2 and T3 (P ＜ 0.05),At T2,SBP,DBP,HR of 5 groups were significantly higher than T3 (P ＜ 0.05).At T0,SBP,DBP,HR among 5 groups showed no significant difference (P ＞ 0.05).At T1 ～ T3,DBP,HR SBP of the 5 groups had a significant difference (P ＜ 0.05),SBP DBP and HR in D group were significantly lower than that of A,B,C groups,and control group (P ＜ 0.05).SBP,DBP,HR in C group were significantly lower than B group,and the control group (P ＜ 0.05).SBP,DBP,HR in B group were significantly lower than A group and the control group (P ＜ 0.0 5);SBP,DBP,HR between A group and control group showed no significant difference (P ＞ 0.05).Conclusion The dose of 0.4 μg/(kg · h) for PIH patients with cesarean section has stable hemodynamics.With the increase of dexmedetomidine dose,the effect is more obvious.