标题：预负荷输注胶体液联合小剂量腰硬联合麻醉对剖宫产产妇术中心血管系统稳定性的影响

      作者：古兵虹，李九红，马长龙，贾双玮    (北京市上地医院麻醉科，北京 100084)

      卷次： 2018年29卷7期

      【摘要】 目的 探讨预负荷输注胶体液联合小剂量腰硬联合麻醉对剖宫产产妇术中心血管系统稳定性的影响。方法 选择2017年1~3月在北京市上地医院行剖宫产术的产妇200例为研究对象，采用随机数表法将患者分为晶体液预负荷联合腰麻组(A组)、胶体液预负荷联合腰麻组(B组)、晶体液预负荷联合小剂量腰硬联合麻醉组(C组)和胶体液预负荷联合小剂量腰硬联合麻醉组(D组)，每组50例。比较四组产妇的麻醉效果、心血管系统不良反应发生率、麻黄素使用量、新生儿出生后Apgar评分、脐动脉血气分析结果。结果 四组产妇的麻醉效果比较差异无统计学意义(P>0.05)；术中低血压不良反应发生率A组最高，其次依次为C组、B组、D组，心律失常发生率A组最高，其次为B组、C组，D组最低，恶心呕吐发生率A组最高，其次为C组，B组与D组最低，麻黄素用量A组最大，其次为B组、C组、D组最低，以上各项指标比较，差异均有统计学意义(P<0.05)四组新生儿Apgar评分及脐动脉血气分析结果比较差异均无统计学意义(P>0.05)。结论 使用胶体液预负荷联合小剂量腰硬联合麻醉能够达到较好的麻醉效果，且对患者的心血管系统稳定性影响小。
      【关键词】 预负荷输液；小剂量腰硬联合麻醉；剖宫产；心血管系统
      【中图分类号】 R719.8 【文献标识码】 A 【文章编号】 1003—6350（2018）07—0942—04

Effect of preload infusion of colloid solution combined with low dose combined spinal epidural anesthesia onstability of cardiovascular system in cesarean section.
GU Bing-hong, LI Jiu-hong, MA Chang-long, JIA Shuang-wei.Department of Anesthesiology, Beijing Shangdi Hospital, Beijing 100084, CHINA
【Abstract】 Objective To discuss the effect of preload infusion of colloid solution combined with low dosecombined spinal epidural anesthesia on stability of cardiovascular system in cesarean section. Methods A total of 200cases for cesarean section from January 2017 to March 2017 in Beijing Shangdi Hospital were selected as study objects.All cases were divided into group A (preload infusion of crystalloid fluid combined with lumbar anesthesia), group B(preload infusion of colloid solution combined with lumbar anesthesia), group C (preload infusion of crystalloid fluidcombined with low dose combined spinal epidural anesthesia), group D (preload infusion of colloid solution combinedwith low dose combined spinal epidural anesthesia) according to random number table method, with 50 cases in eachgroup. The effect of anesthesia, the incidence of adverse cardiovascular reactions, ephedrine usage, Apgar score afterbirth, and umbilical artery blood gas analysis of the four groups were compared. Results There was no significant dif-ference among the four groups in the effects of anesthesia (P>0.05). The incidence of adverse reactions during intraopera-·论 著·doi:10.3969/j.issn.1003-6350.2018.07.017基金项目：北京市医学技术科研项目(编号：20150687)