摘要
目的观察羟乙基淀粉预扩容对联合腰麻下剖宫产手术病人循环和血浆内皮素(ET)、心钠素(ANP)的影响。方法30例剖宫产手术病人随机分为两组:羟乙基淀粉组(HES组)和复方乳酸钠组(LR组),每组15例。病人进入手术室开放外周静脉后快速输注两种液体各1000ml,并同时施行联合腰麻,记录BP、HR、SpO2的数值并分别于输液前(T0)、输液结束后(T1)、手术结束后30min(T2)抽静脉血测定血浆中ET、ANP的含量。结果两组病人麻醉后的BP较麻醉前均有明显下降(P<0.05);HES组ET、ANP的浓度没有明显的变化,而LR组ET、ANP的浓度较输液前明显增加并持续到手术结束(P<0.05)。结论羟乙基淀粉预扩容处理不但能维持联合腰麻下行剖宫产手术病人的循环稳定,而且能有效的减少ET、ANP等应激激素的释放。
Objective To observe the effects of pre-anesthetic volume expansion with hydroxyethyl starch on hemodynamics and ET,ANP in patients undergoing cesarean section under combined spinal and epidural anesthesia.Mehtods Thirty patients with cesarean section were randomly divided into: hydroxyethyl starch group(n=15),and lactate ringer's solution group(n=15).All the patients were infused with (1000ml) hydroxyethyl starch or lactate ringer's solution, the combined spinal and epidural anesthesia were administrated at the same times. The changes of blood pressure,heart rate and oxyhemoglobin saturation were monitored and the concentrations of plasma endothelin and atrial natriuretic peptide were measured before infusion,after infusion and at 30min after operation.Results(The blood) pressure of two groups declined in different degrees (P<0.05) but there was no singificantly difference between two groups (P>0.05).The concentrations of plasma endothelin and atrial natriuretic peptide had no significant changes hydroxyethyl starch group (P>0.05),but increased significantly in lactate ringer's group (P<0.05).Conclusion Pre-anesthetic volume expansion with hydroxyethyl starch can not only maintain stable hemodynamics during combined spinal and epidural anesthesia but also efficiently decrease secretion of endothelin and atrial natriuretic peptide.
出处
《临床麻醉学杂志》
CAS
CSCD
2005年第7期461-463,共3页
Journal of Clinical Anesthesiology
