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小剂量布比卡因腰-硬膜外阻滞对剖宫产产妇相关指标的影响
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| 篇名： | 小剂量布比卡因腰-硬膜外阻滞对剖宫产产妇相关指标的影响 |
| TITLE： | |
| 摘要： | 目的：探讨小剂量布比卡因腰-硬膜外阻滞对剖宫产产妇相关指标的影响。方法：124例择期行剖宫产术的足月单胎初产妇随机分为观察组（62例）和对照组（62例）。观察组产妇给予等比重0.5％布比卡因7.5 mg腰麻 +1.6％利多卡因硬膜外阻滞；对照组产妇给予等比重0.5％布比卡因10 mg腰麻+1.6％利多卡因硬膜外阻滞。观察两组麻醉前（T0），麻醉后1 min（T1）、3 min（T2）、5 min（T3），切皮时（T4），胎儿娩出后（T5）的心率（HR）、收缩压（SBP）、舒张压（DBP），感觉阻滞起效时间、阻滞平面固定时间及手术开始时间，牵拉反应及仰卧位低血压综合征发生情况，麻黄素使用情况，新生儿评分及不良反应发生情况。结果：两组妊娠期妇女T0时HR、SBP、DBP 比较，差异均无统计学意义（P＞0.05）。观察组妊娠期妇女不同时间点的HR、SBP、DBP比较，差异均无统计学意义（P＞0.05）。对照组妊娠期妇女T1-3时 SBP、DBP显著低于同组T0时及观察组同期，HR均显著高于同组T0时及观察组同期，差异均有统计学意义（P＜0.05），但对照组妊娠期妇女同组间T1-3时比较，差异均无统计学意义（P＞0.05），且对照组妊娠期妇女T4-5时HR、SBP、DBP与T0时及观察组同期比较，差异均无统计学意义（P＞0.05）。观察组妊娠期妇女感觉阻滞起效时间、阻滞平面固定时间及手术开始时间均显著长于对照组，仰卧位低血压综合征发生率、麻黄素使用率、麻黄素使用剂量、恶心呕吐发生率、术后尿潴留发生率均显著低于对照组，牵拉反应发生率显著高于对照组，差异均有统计学意义（P＜0.05）。两组妊娠期妇女呼吸抑制发生率、新生儿评分及不良反应总发生率比较，差异均无统计学意义（P＞0.05）。结论：小剂量布比卡因腰-硬膜外阻滞用于剖宫产产妇的血流动力学稳定，可降低仰卧位低血压综合征发生率，且未增加不良反应的发生。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of small dose of bupivacaine lumbar-epidural block on related indexes in women underwent cesarean section. METHODS： 124 singleton term primipara underwent elective cesarean section were randomly divided into observation group （62 cases） and control group （62 cases）. Observation group received 0.5％ bupivacaine 7.5 mg lumbar anesthesia+1.6％ lidocaine epidural block. Control group received 0.5％ bupivacaine 10 mg lumbar anesthesia+1.6％ lidocaine epidural block. HR， SBP， DBP， onset time of sensory block， fixation time of block level， operation start time， the occurrence of traction reaction and supine hypotensive syndrome， the application of ephedrine， Apgar score the occurrence of ADR were observed in 2 groups before anesthesia （T0），1 （T1），3 （T2），5 min （T3） after anesthesia， at skin incision （T4）， after fetal disengagement （T5）. RESULTS： There was no statistical significance in HR， SBP and DBP between 2 groups at T0（P＞0.05）. There was no statistical significance in HR， SBP and DBP of observation group at different time points （P＞0.05）. At T1-3， SBP and DBP of control group were significantly lower than at T0 and observation group； HR was significantly higher than at T0 and observation group， with statistical significance （P＜0.05）； there was no statistical significance in HR，SBP and DBP of control group，compared to at T1-3（P＞0.05）； there was no statistical significance in above 3 indexes of control group at T4-5， compared to at To and observation group（P＞0.05）. The onset time of sensory block， fixation time of block level and operation start time in observation group were all longer than control group； the incidence of supine hypotensive syndrome， the number of ephedrine cases， the amount of ephedrine， the incidence of nausea and vomiting，the incidence of postoperative urinary retention were significantly lower than control group； the incidence of traction reaction was significantly higher than control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of respiratory depression，Apgar score，overall incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： The small dose of bupivacaine lumbar-epidural block for women underwent cesarean section keep hemodynamics stable and reduce the incidence of supine hypotensive syndrome without increasing the incidence of ADR. |
| 期刊： | 2017年第28卷第9期 |
| 作者： | 韩田，谢秋明，郭会江，褚慧贤 |
| AUTHORS： | HAN Tian，XIE Qiuming，GUO Huijiang，CHU Huixian |
| 关键字： | 布比卡因；小剂量；硬膜外阻滞；剖宫产 |
| KEYWORDS： | Bupivacaine； Small dose； Epidural block； Cesarean section |
| 阅读数： | 196 次 |
| 本月下载数： | 2 次 |
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