剖宫产术麻醉前用缩合葡萄糖液预扩容的临床效果观察

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1、剖宫产手术麻醉前用缩合葡萄糖液预扩容效果及安全性的临床观察周幼珍何妹仪李丽龚文魁何建伟(佛山市禅城中心医院麻醉科广东，佛山,528031)摘要目的观察腰硬联合麻卜•剖宫产手术病人使用缩合術萄糖氯化钠注射液预扩容的效果和安全性。方法把50例一般情况良好，即将进行剖宫产术的产妇随机分成两组，各25例，分别命名为缩合匍萄糖氯化钠注射液组(PG组)和复方乳酸钠组(RL组)，于麻醉询按15mL/kg.h-'的速度分别输入缩合葡萄糖氯化钠注射液和复方乳酸钠注射液15mL/kg,并记录分析预扩容前(开放补液后)、预扩容后(麻醉前)、麻醉后

2、5min、lOmin、15min、20min平均动脉压(MAP)、心率(HR)变化，预扩容前、预扩容后Het、pH、Glu、APTT、PT的变化，麻醉后使用麻黄素的病例、术后低血压病例及输液不良反应，麻醉时间和手术时间等。结果麻醉后RL组MAP、HR变化的幅度与其麻醉前及PG组相比均貝有显著性的差异(P

3、反应。结论剖宫产术病人使用缩合葡萄糖氯化钠注射液预扩容，能冇效抵制腰一破联合麻醉所产生的心血管变化，适量使用不会明显影响血液凝固和提升血糖。关键词剖宫产；缩合葡萄糖；预扩容；效果；安全性Clinicalobservationofefficacyandsecurityofpre-anesthetichypervolemichemodilutionwithpolyglucosebeforecesareansectionZHOUYouzhen,HEmeiyi,LILi,ctal(DcpartmcntofAnesthesiaofCh

4、an-chcngBoroughTheMiddle'sHospital,FOshan528031,Guangdong,P.R.China)AbstractObjectiveToobservetheeffectsandsecurityofpre-anesthetichypervolemichemodilutionwithpolyglucosesodiumchlorideonpatientstakingcesareansectionundercombinedspinal-epiduralanesthesia.Methods5()c

5、ases,generallygoodandwillsoonundertakingmaternalcesareansection,wererandomlydividedintotwogroups,25casesforeach,namedaspolyglucosesodiumchlorideinjection(PG)groupandcompoundsodiumlactate(RL)group・Thepatientsinthetwogroupswererespectivelyinjectedwithpolyglucosesodiu

6、mchlorideandcompoundsodiumlactateataspeedof15mL/kg.h-1・Thechangesofmeanarterialpressure(MAP)andheartrate(HR)beforeandafterpre-anesthetichypervolemichemodilution,5min,lOmin,15min,20minafteranesthesia,andthechangesofHet,pH,Glu,APTT,PTbeforeandafterpre-anesthetichyper

7、volemichemodilution,andthecaseshadephedrineafteranesthesia,thecaseswithlowpostoperativebloodpressure,infusionadversereactions,anesthesiatimeandsurgicaltimewerealsorecordedandanalyzed.ResultsTheMAPandHRafteranesthesiainRLgroupsweresignificantlydifferentfromthatbefor

8、eanesthesiaandthatinPGgroup(P<0.01).Afterpre-anesthetichypervolemichemodilution,theHet,pH,Glu,APTT,PTchangedsignificantly(P<0.05or0.01),butstillw