[1]张 博,高辰飞,高成杰.LiDCO监测下预泵注甲氧明对剖宫产产妇血流动力学及新生儿的影响[J].陕西医学杂志,2021,50(8):987-991.[doi:DOI:10.3969/j.issn.1000-7377.2021.08.021]
　ZHANG Bo,GAO Chenfei,GAO Chengjie.Effect of pre-pumped methoxamine on maternal hemodynamics and foetus in cesarean section under LiDCO monitoring[J].,2021,50(8):987-991.[doi:DOI:10.3969/j.issn.1000-7377.2021.08.021]
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LiDCO监测下预泵注甲氧明对剖宫产产妇血流动力学及新生儿的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年8期
页码:
987-991
栏目:
临床研究
出版日期:
2021-08-05

文章信息/Info

Title:
Effect of pre-pumped methoxamine on maternal hemodynamics and foetus in cesarean section under LiDCO monitoring
作者:
张 博1; 高辰飞2; 高成杰3
(1.西安市人民医院 西安市第四医院麻醉科,陕西 西安 710004; 2.山东第一医科大学基础医学部,山东 济南 250000; 3.解放军九六〇医院麻醉科,山东 济南 250031)
Author(s):
ZHANG Bo; GAO Chenfei; GAO Chengjie
(Department of Anesthesiology,Xi'an People's Hospital,Xi'an 710004,China)
关键词:
甲氧明;  椎管内麻醉;  剖宫产;  血流动力学;  Apgar评分;  脐动脉血气
Keywords:
Methoxamedrin;  Intraspinal anesthesia;  Caesarean section;  Hemodynamic;  Apgar score;  Umbilical artery blood gas
分类号:
R 614.4
DOI:
DOI:10.3969/j.issn.1000-7377.2021.08.021
文献标志码:
A
摘要:
目的:探讨LiDCO无创血流动力学分析仪监测母体血流动力学及胎儿脐动脉血气分析对预泵注不同剂量甲氧明对椎管内麻醉剖宫产产妇血流动力学及新生儿的影响。方法:选择接受椎管内麻醉行剖宫产的单胎足月产妇90例,随机分为三组(M0、M1、M2组),每组30例; 其中M1、M2组产妇入室后即刻泵入甲氧明1.5、2.5 μg/(kg·min),三组产妇出现低血压时均单次补救式静脉注射甲氧明1 mg。采用LiDCO无创血流动力学分析仪观察产妇剖宫产手术时不同时期的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、心排血量(CO)、外周阻力(SVR)及有无恶心、呕吐、呼吸困难,并观察胎儿娩出后Apgar评分及脐动脉血气分析数据。结果:相较于M0组,M1和M2组的MAP、HR、CO、SVR的波动明显较小(均P<0.05),M2组恶心、呕吐、呼吸困难的发生率显著低于M0、M1组(均P<0.05)。M2组并未因低血压而补救式给予甲氧明,与M1组对比补救率显著降低(P<0.05)。三组的新生儿Apgar评分及脐动脉血气分析比较均无统计学意义(均P>0.05)。结论:在椎管内麻醉剖宫产手术中预泵注小剂量甲氧明比补救式给予甲氧明的产妇血流动力学更稳定,对新生儿Apgar评分及脐动脉血气分析无影响,且预泵注2.5 μg/(kg·min)甲氧明产妇出现不良反应更少,血流动力学更加稳定。
Abstract:
Objective:To investigate the effect of pre-pumping different doses of methoxamine on the hemodynamics of intraspinal cesarean section maternal hemodynamics and neonates in cesarean section under the monitoring of LiDCO non-invasive hemodynamic analyzer.Methods:90 single-term mothers who underwent intraspinal anesthesia for cesarean section were selected and randomly divided into three groups(M0,M1,M2 group),30 cases in each group.The M1,M2 group was pumped with methoxamine 1.5 and 2.5 μg/(kg·min)immediately after entering the room,respectively.When hypotension occurred in the three groups,women in all three groups received a single salvage intravenous injection of methoxamine 1 mg.The LiDCO non-invasive hemodynamic analyzer was used to observe the mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2),cardiac output(CO),systemic vascular resistance(SVR).The presence or absence of nausea,vomiting,dyspnea,and the Apgar score and umbilical artery blood gas analysis data were observed after the fetus is delivered.Results:Compared with M0 group,MAP,HR,CO and SVR of M1 and M2 groups in different periods were significantly less instability(all P<0.05).The incidence of nausea,vomiting and dyspnea in M2 groups was significantly lower than that in M0 group and M1 group(all P<0.05).M2 group did not receive methoxamine for hypotension,and the recovery rate was significantly lower than that of M1(P<0.05).Apgar scores and umbilical artery blood gas analysis were not statistically significant in the three groups(all P>0.05).Conclusion:Pre-pumped low-dose methoxamine during cesarean section with intraspinal anesthesia is more stable than that of salvage-administered methoxamine,and has no effect on the newborn Apgar score and umbilical artery blood gas analysis.Pre-pump injection of 2.5 μg/(kg·min)methoxamine has fewer adverse reactions and more stable hemodynamics.

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更新日期/Last Update: 2021-08-05