中山大学学报（医学科学版）2012，Vol.33Issue(4)：528-531,4.
高渗氯化钠羟乙基淀粉40对产妇腰麻后低血压及新生儿早期安全的影响
Influence of Hypertonic Sodium Chloride Hydroxyethyl Starch 40 on Hypotension Induced by Spinal Anesthesia for Cesarean Delivery and on Neonate
摘要
Abstract
[Objective] To evaluate the influence of hypertonic sodium chloride hydroxyethyl starch 40 (HSH40) on hypotension induced by spinal anesthesia for cesarean delivery and on neonate. [Methods] Sixty termed parturients (ASA Ⅰ-Ⅱ) scheduled for cesarean section were randomly divided into Croup HSH40 (n = 30) and Group RL (n = 30). HSH40 250 mL and Ringer lactate solution 500 mL were infused in 15 to 20 nun before intrathecal administration of local anesthetics in Group HSH40 and Group RL, respectively. Spinal anesthesia was performed at lumber 3/4 interspaces with 0.5 % bupivocaine 2 mL. Incidence of severe hypotension (Systolic blood pressure ＜100 tnmHg, 1 mmHg = 0.133 kP ) was recorded in 15 min after induction of spinal anesthesia. The Apgar scores at 1 and 5 minutes were evaluated and the umbilical blood samples were collected for blood gas analysis. [Results] Patient characteristics were comparable between the two groups (P ＞ 0.05). In 15 min after intrathecal administration of local anesthetics, the incidence of hypotension (Systolic blood pressure )＜ 100 mmHg,＜ 90 mmHg and ＜ 80 mmHg in Group RL and Group HSH40 were 80.0 % vs 40.0 %, 63.3 % vs 10.0 %, and 40.0 % vs 6.7 %, respectively (P＜ 0.01). No difference in blood gas analysis of umbilical blood samples was found (P ＞ 0.05). The sodium concentration of umbilical blood samples was higher in Group HSH40 than in Group RL {P ＜ 0.01). [Conclusion] HSH40 preloading can not eliminate severe hypotension induced by spinal anesthesia for cesarean section, can not improve the early outcome of the neonates, but increased sodium concentration in umbilical cord, it should be prudent to use cesarean delivery.关键词
高渗羟乙基淀粉注射液40/剖宫产术/腰麻/腰硬联合麻醉/低血压/脐带血血气分析/Apgar评分Key words
hypertonic sodium chloride hydroxyethyl starch 40 Injection/ cesarean delivery/ spinal anesthesia/ combined spinal and epidural anesthesia/ hypotension/ umbilical cord blood gas analysis/ Apgar scores分类
医药卫生引用本文复制引用
陈洁琳,周舸,林琳,张莉莉,孙文琴,刘明姬,莫利求..高渗氯化钠羟乙基淀粉40对产妇腰麻后低血压及新生儿早期安全的影响[J].中山大学学报（医学科学版）,2012,33(4):528-531,4.基金项目
2009年吴孟超医学科技基金(RG-D2009060) （RG-D2009060）
