国产羟已基淀粉预扩容用于腰—硬联合麻醉下剖宫产术的临床观察

目的观察国产羟已基淀粉预扩容用于腰—硬联合麻醉下剖宫产术中预防低血压等不良反应的效果。方法将100例剖宫产手术患者,随机分为A组和B组,每组50例,A、B两组于麻醉前分别快速输入国产羟已基淀粉氯化钠注射液和复方氯化钠注射液各500ml预扩容,观察术中产妇的生命体征变化及恶心、呕吐等不良反应及使用麻黄碱情况。结果腰麻注药后,两组患者的SBP、DBP均有所下降,但A组下降不明显,与基础值比较差异无显著性(P>0.05),B组下降明显,与基础值比较差异有显著性(P<0.05或P<0.01);A组低血压、恶心、呕吐发生率及麻黄碱使用率明显低于B组(P<0.01或P<0.05);两组HR改变不明显(P>0.05)。结论麻醉前预充国产羟已基淀粉氯化钠注射液能有效地减少剖宫产腰麻后低血压等不良反应的发生率,提高剖宫产产妇及其胎儿的安全性。

Hetastarch pretreatment in combined spinal - epidural anaesthesia for cesarean section

Objective The efficacy of hetastarch （made （hypotension, et al） in combined spinal-epidural anaesthesia in China）pretreatment for prevention of complications for cesarean section was evaluated. Methods 100 patients undergone cesarean section were randomly divided into group A and group B, 50 cases in each group. Group A received 500ml hetastarch sodium chloride infusion and and group B received 500ml compound sodium chloride infusion before anaesthesia. During surgery, the parturients＇ symptoms and signs, the complication of nausea and vomiting, and the use of ephedrine were recorded. Results After combined spinal-epidural injection, both SBP and DBP decreased in the two groups, but group A decreased slightly, there was no significant difference compared to baseline values （ P〉0.05）. Group B decreased significantly compared to baselines （ P 〈0.05 or P 〈0.01） . In group A, the incidences of hypotension, nausea and vomiting and the use of ephedrine were lower than those in group B （ P 〈 0.05 or P 〈 0.01 ）. HR in both groups A and B changed slightly （ P〉0.05）. Conclusion Hetastarch sodium chloride pretreatment before combined spinal - epidural anaesthesia can effectively decrease the incidence of complications, such as hypotension, et al for cesarean section, and improve the safety of parturients and fetus during cesarean section.