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腰麻联合硬膜外麻醉下应用贺斯预防低血压的临床研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第3期
页码:
183-185
栏目:
论著
出版日期:
2000-05-25

文章信息/Info

Title:
Clinic study of hetastarch for prevention of hypotention during combined spinal and epidural anesthesia
作者:
胡胜1;  计根林1;  陈绍洋1;  梁良2;  朱箫玲1;  张英民1
1 第四军医大学西京医院麻醉科, 陕西西安710033; 2 铜川市矿务局中心医院
Author(s):
HU Sheng1;  JI Gen-lin1;  CHEN S hao-yang1;  LIANG Liang2;  ZHU Xiao-ling1;  ZHANG Ying-min1
1Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710033, Shaanxi, China； 2 Department of Anesthesiology, Central Hospital of Tong Chuan mineral bureau
关键词:
腰麻联合硬膜外麻醉; 贺斯; 乳酸林格氏液; 血压; 心率
Keywords:
combined spinal and epidural anesthesia;  hetastarch;  lactated ringer's solution;  blood pressure; heart rate
分类号:
R614
DOI:
-
文献标识码:
A
摘要:
目的 比较60 ml/L贺斯（HES）和乳酸林格氏液对预防腰麻联合硬膜外麻醉（CESA）下低血压的作用。方法 CESA择期行妇科手术患者22例，随机分为两组，静脉输注60 ml/L贺斯或乳酸林格氏液500 ml，观察收缩压（SBP）、舒张压（DBP）、心率（HR）和脉搏血氧饱和度（SPO2）的变化。结果 两组患者上述指标基本稳定，与基础值相比，差异不显著（P＞0．05）。结论 输注60 ml/L贺斯或乳酸林格氏液均能有效地防止CESA后血压降低，两者作用无明显差异。
Abstract:
AIM The purpose of this study was to compared the efficacy of 60 ml/L hetastarch in saline(HES) versus lactated ringer's solution for prevention of hypotention during combined spinal and epidural anesthesia(CESA). METHODS 22 patients classified as ASA status Ⅰ-Ⅱ who were scheduled for hysterectomy under CESA were enrolled in this study. They were randomized into two groups to infuse 500 ml 60 ml/L HES or 500 ml lactated ringer's solution, The variety of systolic blood pressure (SBP), diastolic blood pressure(DBP), heart rate(HR) and oxyhemoglobin saturation were monitored. RESULTS Both groups were equally effective in preventing hypotention and the hemodynamic values were stable compared with the baseline. There were no significant difference(P＞0.05). CONCLUSION infusion of 500 ml HES or 500 ml ringer's solution intravenously was an effective prevention for ESCA induced hypotension, There was no different between HES and ringer's solution.

参考文献/References

［1］ 郑恒兴，计根林，张英民, 等。腰麻联合硬膜外麻醉在全子宫切除术的应用［J］。中华麻醉学杂志，1999,19(2):122.

［2］ 秦秉玉，张继兵，孟凡民, 等.负压气囊在椎管内联合麻醉穿刺中的应用［J］. 中华麻醉学杂志, 1999,19(5):320.

［3］ Felsby S, Juelsgaard P. Combined spinal and epidural anesthesia［J］. Anesth Analg, 1995,80（4）:825.

［4］ Kohler H, Zschiedrich H, Clasen R et al. 10% Blood volume, colloid osmotic pressure, and kidney function of healthy volunteers following infusion of mediummoleculan-weight 10% hydroxyethyl starch 200/0.5 and 10% dextran 40［J］. Anaesthesist, 1982,31（1）:61.

［5］ Lifschitz R, Jedeikin R. Spinal epidural anesthesia:a new combination system［J］. Anesthesia, 1992,47（6）:503.

［6］ Norris MC, Grieco WM, Borkowski M, et al. Complications of labor analgesia: Epidural versus combined spinal epidural techniques［J］. Anesth Analg, 1994,79(3):529.

［7］ 赵　宏，卢丽萍，崔健君. 硬膜外阻滞剖宫产术中静脉输液预防低血压的初步研究［J］。中华麻醉学杂志, 1995,15(8):353.

［8］ Radel HK, Chis BM, Iawiewski P et al. Comparison of hydroxyethyl starch and lactated ringeri's solution on hemodynamics and oxygen transport of critically ill patients in prospective cros sover studies［J］. Crit Care Med, 1989,17(2):133.

备注/Memo

备注/Memo:
收稿日期：1999-07-23.
更新日期/Last Update: 2000-05-25