文章摘要
王群,王猛,沈明坤,等.比较5-羟色胺3受体拮抗剂在预防剖宫产术中低血压的效果及对母婴的影响[J].安徽医药,2017,21(6):1087-1090.
比较5-羟色胺3受体拮抗剂在预防剖宫产术中低血压的效果及对母婴的影响
Compare the hypotension prevention effect of different 5-HT3 receptor antagonist in fetal and maternal during cesarean delivery with spinal anesthesia
投稿时间:2016-06-16  
DOI:
中文关键词: 5-羟色胺3受体拮抗剂  低血压  脊柱麻醉  剖宫产术
英文关键词: 5-HT3 receptor antagonist  Hypotension  Spinal anesthesia  Cesarean delivery
基金项目:江苏省妇幼健康科研项目(F201544);无锡市卫生局科技项目(ML201205)
作者单位E-mail
王群 无锡市妇幼保健院麻醉科,江苏 无锡 214002  
王猛 无锡市妇幼保健院麻醉科,江苏 无锡 214002 wxfy2071@163.com 
沈明坤 无锡市妇幼保健院麻醉科,江苏 无锡 214002  
余燕云 无锡市妇幼保健院麻醉科,江苏 无锡 214002  
郁君静 无锡市妇幼保健院麻醉科,江苏 无锡 214002  
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中文摘要:
      目的 比较脊柱麻醉前静注不同5-羟色胺3(5-HT3)受体拮抗剂预防脊柱麻醉下剖宫产术中低血压的效果以及对产妇和胎儿的影响。方法 拟择期在脊柱麻醉下行剖宫产术的单胎足月妊娠产妇120例,按随机数字表法分为S组、T组、G组、A组,每组30例,分别在脊柱麻醉前5 min静脉推注生理盐水5 mL(S组),托烷司琼5 mg(T组)、格拉司琼3 mg(G组)、阿扎司琼10 mg(A组)(所有药物使用生理盐水稀释至5 mL)。从脊柱麻醉鞘内注药2 min后开始,每隔2 min测量并记录一次血压、心率和血氧饱和度(SpO2)直至鞘内注药30 min。胎儿娩出后即刻取胎儿脐动脉和脐静脉的血标本行血气分析。结果 G组产妇术中低血压和恶心的发生率明显低于S组(P<0.05),G组脐静脉血的二氧化碳分压[p(CO2)]明显低于S组(P<0.05),T组和A组的恶心发生率明显低于S组(P<0.05)。G组和A组脐静脉血的pH值明显高于S组而碳酸氢根离子(HCO-3)浓度明显低于S组(P<0.05),T组的HCO-3浓度也明显低于S组(P<0.05)。G组产妇术中收缩压最大下降值明显小于S组(P<0.05)。结论 脊柱麻醉前静注5-HT3受体拮抗剂可以一定程度上减少产妇脊柱麻醉后血压的下降以及产妇低血压和恶心的发生,从而改善脐静脉的酸碱状态。
英文摘要:
      Objective To compare the hypotension prevention effects of different 5-HT3 receptor antagonist on the fetal and maternal prophylactic intravenous during cesarean delivery with spinal anesthesia.Methods One hundred and twenty mature pregnant women with single-embryo scheduled for elective cesarean section were randomly divided into four groups(Group S,T,G and A,n=30).Five minutes prior to spinal anesthesia,women were injected IV saline 5 mL (S),tropisetron 5 mg (T),granisetron 3 mg (G),azasetron 10 mg (A) (the drug was diluted to 5 mL with saline).After 2 min of spinal injection,maternal BP,HR and SpO2 were measured at 2 min intervals for 30 min.After delivery,umbilical arterial and umbilical venous blood samples were taken for the measurements of blood gases.Results The incidences of hypotension and nausea in group Gwere significantly lower than in group S (P<0.05).The incidences of nausea in group Tand Awere significantly lower than in group S(P<0.05).The pH values of umbilical venous in group Gand Awere significantly higher than in group S (P<0.05),partial pressure of carbon dioxide p(CO2) in group Gwas ower than in group S(P<0.05),while the bicarbonate (HCO-3) in group G,T and Awere significantly lower than in group S (P<0.05).The decrease of SBP in group Gwas significantly lower than in group S (P<0.05).Conclusion To a certain extent,intravenous 5-HT3 receptor antagonist before spinal anesthesia could significantly reduce the drop of maternal blood pressure after spinal anesthesia and the incidences of maternal hypotension and nausea,which improve the acid-base status of umbilical vein.
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