七氟醚对重度子痫前期患者血流动力学影响的临床观察

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1、七氟醚对重度子痫前期患者血流动力学影响的临床观蔡恒宇郜红艳(沈阳市妇婴医院麻醉科辽宁沈阳110000}【摘要】目的：观察七氟醚吸入麻醉在重度子痫前期患者胎儿娩出前对产妇血流动力学的影响。方法：择期剖宫产术的重度子痫前期产妇40例，平均分为二组，C组选择联合阻滞麻醉，S组选择七氟醚吸入麻醉。记录患者麻醉前、麻醉后2、5、8、lOmin及胎儿娩出时的MAP、HR，同时记录麻醉幵始至手术开始时间，手术开始至胎儿娩出的时间和子宫切开至胎儿娩出时间、血管活性药物应用量及新生儿1min、5minApgar评分。结果：母体术中HR变化，S组与C组麻醉后比较2min和lOmin

2、有差异，母体术中MAP变化，S组与C组麻醉后5min有差异。二组麻醉开始至手术开始时间有差异。二组产妇在胎儿剖出前麻黄碱使用率和胎儿剖出前使用麻黄碱总量比较均有统计学差异。结论：七氟醚吸入麻醉用于重度子痫前期患者在胎儿娩出前血流动力学方面比联合阻滞麻醉更稳定，减少低血压发生率，降低血管活性药物在胎儿娩出前的使用，是一种相对安全可行的麻醉方式。【关键词】重度子痫前期患者腰硬联合麻醉七氟醚剖宫产【中图分类号】R614【文献标识码】A【文章编号】2095-1752(2014)19-0121-02AClinicalObservation:Theeffectsofsevo

3、fluranetoHemodynamicChangesinPreeclampsiaPatientsusingCesareanSectionCAIHeng-yuGAOHongyan(DepartmentofAnesthesiology,ShenyangWomen’sandChildren’sHospital,Shenyangll0000,China)【Abstract】Objective:ToobservetheeffectsofsevofluranetoMAP,HRinpreeclampsiapatientsusingcesareanse

4、ctiontillthenewborndelivery.Methods：40parturientswithseverepreeclampsia,ASAH-III,forcesareansectionwereequallyintocombinespinal-epiduralanaesthesiagroup(C,n=20)andsevofluraneinhalationanesthesiagroup(S,n=20).MAPandHRweremonitoredatthetimepointsofbeforeanesthesia,2,5,8,lOminafteranest

5、hesiaandthemomentofneonatusexpulsion.Thetimefrominductiontostrikingskin，fromstrikingskintonewborndeliver,fromstrikinguterustonewborndeliverandthedosageofephedrinewasrecorded.Apgarscoreofneonatewasassessed.Results：TheHRwasdecreasedobviouslyatthetimepointsof2,10min.TheMAPingroupSwashig

6、herthanthatingroupCatthetimepointsof5min.Thetimefrombetweeninductionandstrikingskinwasdecreasedobviously.ThedosageofephedrineingroupSwasfewerthenthatingroupC.Conclusion：Itisansafeandeffectivemeasurementtostablematernalhemodynamicsthatsevofluraneinhalationanesthesiaforcesareansectionw

7、ithseverepreeclampsiatoreducetheincidenceofhypotensionanddosageofephedrineusedtillthenewborndelivery.LKeywords]severepreeclampsiasevofluranecombinedspinal-epiduralanesthesiacesareansec-tion对于重度子痫前期产妇实施剖宫产的麻醉方式始终存在一定的争议，椎管内阻滞由于交感神经被阻断血管扩张，伴随此类产妇全身血管处于痉挛状态，全身血容量相对不足，采用椎管内阻滞发生低血压风险较高，采用

8、全身麻醉很多药物能通过胎