聚明胶肽预充对腰麻-硬膜外联合阻滞剖宫产产妇血液动力学的影响

目的:研究比较应用聚明胶肽和林格氏液预防剖宫产手术在联合腰麻-硬膜外麻醉(CSEA)后低血压的发生。方法:60例ASAⅠ～Ⅱ级,年龄22～32岁剖宫产手术的患者,随机分为A、B两组,每组30例在CSEA前,30min内A组输注聚明胶肽500ml,B组林格氏液500ml。CSEA于L2～3椎间隙穿刺,注入0.5%罗哌卡因2m(l重比重),麻醉平面控制在T6水平以下,记录产妇麻醉前、麻醉后3min、5min、10min及术毕产妇的SBP、DBP、HR。结果:麻醉后两组产妇血压皆有下降,但B组下降更明显,两组比较也有显著性差异(P<0.05)。B组麻醉后3min、5min产妇心率增快,与入室时比较有显著性差异P<0.05。结论:麻醉前预充聚明胶肽比林格氏液对减少剖宫产术中引起的低血压更有效。

Effect of polygeline on the circulation function during combined epidural and spinal anesthesia in cesarean section

Objection： To investigate and compare the application of polygeline and Ringer＇s solution in preventing hypotension during combined epidural and spinal anesthesia（CSEA） in cesarean section.Methods： Sixty patients,classified ASA Ⅰ-Ⅱ,aged 22-32,scheduled for the cesarean section,were randomly divided into four groups with 30 cases each.Before CSEA,polygeline or Ringer＇s solution was given 500ml by means of a vein in 30 minutes.CSEA was performed at L2-L3,and after the spinal anesthesia puncture was successful,0.5%Ropivacaine 2ml（hyperbaric solution）was implanted.The level of epidural blockade was controlled under T6.ECG,SpO2 and NIBP were continuously monitored during the operation,and SBP,DBP and HR were recorded before anesthesia,at 3minutes,5minutes,and 10 minutes after anesthesia,and after operation.Results：After CSEA,BP in both groups was reduced,but Group Ringer＇s solution declined significantly,comparisons between the two groups showed significant differences（P0.05）.In Group Ringer＇s solution,maternal heart reta was increased at 3minutes and 5minutes after anesthesia.Compared with noninvasive time,there were significant differences（P0.05）.Conclusion： Intravenous polygeline before anesthesia can prevent hypotension in cesarean section more effectively than Ringer＇s solution.