林格氏液和羟乙基淀粉对椎管内麻醉下择期剖宫产患者血流动力学变化的影响比较
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A Comparison Between the Effects of Preloading with Ringer’s Solution and Voluven on Hemodynamic Changes in Patients Undergoing Elective Cesarean Section Under Spinal Anesthesia
背景与目的
椎管内麻醉剖宫产术后最常见的并发症是低血压。在麻醉诱导之前施用静脉内晶体或胶体液是一种预防低血压的方法。本研究的目的是比较林格氏溶液和羟乙基淀粉对椎管内麻醉下选择性剖宫产患者血流动力学变化的影响。
方 法
这项研究是对70名孕妇进行的。他们被随机分成两组，每组35人。第1组椎管内麻醉前15分钟给予林格液10ml /kg (R组)，第2组给予羟乙基淀粉10ml /kg (V组)。记录两组新生儿出生后1和5分钟平均SBP、DBP、MAP、HR、SPO2、Apgar值、平均血pH值、新生儿脐静脉血气体分析、恶心呕吐发生率、寒颤发生率及严重程度。
结 果
两组新生儿出生后1、5分钟血pH值及血气、Apgar分析结果相似。两组间的寒战发生率没有显著差异。麻醉水平、恶心呕吐发生率R组明显高于V组(P=0.041, P=0.029)。
结 论
晶体和胶体液体都能有效地预防低血压，但就阻滞水平和恶心呕吐的发生率而言，使用羟乙基淀粉比使用林格液更为可取。
原始文献摘要
Fatemeh Khosravi , Mojgan Alishahi, Yaser Khanchemehr. A Comparison Between the Effects of Preloading with Ringer’s Solution and Voluven on Hemodynamic Changes in Patients Undergoing Elective Cesarean Section Under Spinal Anesthesia [J] Med Arch,2019; 2019 FEB; 73(1): 44-48
BACKGROUND: The most common complications after spinal anesthesia for Cesarean section is hypotension. Administration of intravenous crystalloid or colloid fluid before the induction of anesthesia is a way to prevent it.
Aim：The aim of this study was to compare the effects of preloading with ringer's solution and Voluven on hemodynamic changes in patients underwent elective Caesarean section under spinal anesthesia.
Methed:
This study was conducted on 70 pregnant women. They were randomly divided into two groups of 35. Group I received 10 ml/kg Ringer’s solution (R group) and group II received 10 ml/kg Voluven (V group) over 15 min before spinal anesthesia. Mean SBP, DBP, MAP, HR, SPO2, mean Apgar of newborn at 1 and 5 minutes after birth, mean blood pH and analysis of umbilical venous blood gases of newborns, prevalence of nausea and vomiting, and the rate of shivering and its severity were recorded in the both groups.
Results：
Blood pH and analysis of blood gases and Apgar of newborn at 1 and 5 minutes after birth were similar in both groups. Shivering did not differ significantly between the two groups. Level of anesthesia and the incidence of nausea and vomiting in the R group were significantly higher than those in the V group (P=0.041 and P=0.029,respectively).
Conclusion:
The administration of both crystalloid and colloid fluids were effective in preventing the hypotension, although the use of Voluven was preferred to Ringer with respect to the level of the blockade and the incidence of nausea and vomiting.
麻醉学文献进展分享
贵州医科大学高鸿教授课题组
翻译：何幼芹 编辑：李华宇 审校：王贵龙