剖宫产术患者局部注射与静脉注射硝酸甘油子宫松弛效应的比较

目的 比较剖宫产术患者局部注射与静脉注射硝酸甘油的子宫松弛效应.方法 拟行剖宫产术患者60例,年龄25～35岁,ASA分级Ⅰ级,体重60～90kg,随机分为3组(n=20),对照组(C组),静脉注射组(Ⅰ组)分离子宫后静脉注射硝酸甘油0.2 mg,局部注射组(L组)分离子宫后局部注射硝酸甘油0.2 mg.记录胎儿娩出时间、术中出血量,于切子宫、切子宫后3、5、10、15、20 min时记录MAP.结果 与C组比较,Ⅰ组和L组切子宫时MAP降低,胎儿娩出时间缩短,Ⅰ组术中出血量增加,L组术中出血量减少(P＜0.05);与Ⅰ组比较,Ⅱ组切子宫、切子宫后3、5、10 min时MAP升高,胎儿娩出时间缩短,术中出血量减少(P＜0.05).结论 剖宫产术患者子宫局部注射硝酸甘油产生的子宫松弛效应优于静脉注射.

Comparison of efficacy of nitroglycerine administered by local application and intravenous injection for uterine relaxation in patients undergoing caesarean section

Objective To compare the efficacy of nitroglycerine administered by local application and intravenous injection for uterine relaxation in patients undergoing caesarean section. Methods Sixty ASA Ⅰ patients, aged 25-35 yr, weighing 60-90 kg, undergoing caesarean section, were randomly allocated into 3 groups ( n = 20 each): control group (group C), intravenous injection group (group I) and local application group (group L). Combined spinal-epidural block was used in the patients. After isolation of uterus, nitroglycerine 0.2 mg was injected intravenously in group Ⅰ and was injected into uterine muscle in group L. The delivery time, blood loss during operation and MAP at the time of uterus incision and 3, 5, 10, 15 and 20 min after uterus incision were recorded. Results Compared with group C, MAP at the time of uterus incision was significantly decreased and the delivery time was significantly shortened in group Ⅰ and L, and the blood loss during operation was significantly increased in group Ⅰ while decreased in group L ( P ＜ 0.05). MAP at the time of uterus incision and 3, 5, and 10 min after uterus incision was significantly increased, the delivery time was significantly shortened, and the blood loss during operation was significantly decreased in group L compared with group Ⅰ ( P ＜ 0.05). Conclusion Local application of nitroglycerine exerts better efficacy than intravenous injection for uterine relaxation in patients undergoing caesarean section.