7.5%高渗氯化钠联合聚明胶肽注射液对腰麻后剖宫产心血管系统稳定作用

目的 探讨预注7.5%高渗氯化钠联合聚明胶肽注射液对腰麻后剖宫产产妇心血管系统的稳定作用.方法 63例拟行剖宫产的足月产妇,ASA I-II级,随机分为高渗氯化钠联合聚明胶肽（实验,E）组（n=22）、聚明胶肽（P）组（n=26）、乳酸钠林格氏液（RL）组（n=15）.三组产妇在腰麻前15~20 min内静脉输入液体,E组为7.5%氯化钠2.5 ml/Kg＋聚明胶肽2.5 ml/Kg,P组为聚明胶肽5 ml/Kg,RL组为RL 10 ml/Kg.选腰3~4椎间隙穿刺注入0.5%布比卡因2ml腰麻.观察腰麻后5 min、10 min时收缩压变化量（ΔSBP）、脉搏氧饱和度（SpO2）、心率（HR）;产妇麻醉后低血压和心动过缓发生率;各组产妇间羟用量.结果麻醉后5、10 min RL组SBP下降较E、P组明显（P〈0.05）,而HR增加较麻醉前明显（P〈0.05）.麻醉后5 min P组SBP下降较E组明显（P〈0.05）.麻醉后低血压和心动过缓发生率以RL组最高,E组最低;RL组间羟胺用量最多,E组最少（P〈0.05）;各组间差异有统计学意义（P〈0.05）.结论 预注7.5%高渗氯化钠联合聚明胶肽对腰麻后产妇心血管系统稳定作用明显.

Stabilization of cardiovascular system for cesarean section by infusion 7.5% hypertonic saline solution plus polygeline injection before spinal anesthesia

Objective To observe the stabilization of cardiovascular system for Cesarean Section by infusion 7.5% hypertonic saline solution plus polygeline injection before spinal anesthesia. Methods 63 termed parturients（ASA I - II） for cesarean section were randomly divided into Group hypertonic saline plus polygeline injection （ Experimental, E, n = 22）, Group Polygeline （P, n = 26）, Group Lactated Ringer＇s solution （RL, n = 15）. Three groups of parturient were infuse liquid within 15-20 rain before spinal anesthesia, including group E with 7. 5% hypertonic saline sodium chloride （2. 5 ml/kg） plus polygeline injection polygeline 2. 5 （2. 5 ml/kg）, Group P with Polygeline injection 5 mL/kg, Group RL with RL 10 ml/kg. Spinal anesthesia was performed at lumber 3 - 4 interspaces with 0. 5 bupivocaine 2ml. Observe the several experimental index of three groups cesarean after spinal anesthesia in 5 min, 10 min, that include the change of systolic blood pressure （ASBP）, pulse oxygen saturation （SPO2）, heart rate （HR）, the incidence of hypotension and bradycardia and the amount of metaraminol used. Results 5 and 10 min after anesthesia, SBP decreased significantly in group RL compare with group E and P （ P 〈 0. 05 ）, and HR increased significantly （P 〈 0. 05） than before anesthesia. SBP after anesthesia in 5 min decreased significantly in group P compared with group E （P 〈 0. 05）. After anesthesia, the incidence of hypotension and bradycardia in group RL was the highest and the lowest in group E ; the amount of metaraminol used was the largest in group RL and the least in group E （ P 〈 0. 05） ; the differences among the groups was statistically significant （P 〈 0. 05）. Conclusion To infuse 7. 5% hypertonic saline plus polygeline injection before spinal anesthesia have exact role for cesarean section patients cardiovascular system stability.