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目的观察剖宫产术中依心率变化预给去甲肾上腺素预防低血压的效果。方法择期行硬膜外下剖宫产术单胎足月孕妇56例均分为两组,连续监测麻醉前和麻醉后仰卧位1、4、7、10、13、16min时的无创血压与心率。在麻醉后仰卧位时心率超过基础心率的20%时(A组)或在SBP降低超过基础值20%时(B组),静脉给予去甲肾上腺素4μg。记录去甲肾上腺素的使用率,观察不良反应的发生情况。结果两组产妇在麻醉后仰卧位7min时,A组SBP高于B组[(115±12)mmHg vs.(95±12)mmHg](P<0.05);两组各时间点心率变化差异无统计学意义(P>0.05)。两组去甲肾上腺素使用率相仿[38.5%(10/26)vs.36.0%(9/25)](P>0.05)。A组产妇头晕、恶心、心慌胸闷的不良反应发生率低于B组(P<0.01)。结论剖宫产术中依心率变化预给去甲肾上腺素能及时有效预防低血压,从而减少不良反应的发生。
Objective To observe the effect of norepinephrine preconditioning on prevention of hypotension according to changes of heart rate during cesarean section. Methods Elective subdural cesarean section singletonic term pregnant women, 56 cases were divided into two groups, continuous monitoring before anesthesia and anesthesia supine position at 1,4,7,10,13,16 min noninvasive blood pressure and heart rate . Nalpinephrine 4 μg was intravenously administered when the heart rate exceeded 20% of the basal heart rate in the supine position after anesthesia (group A) or when SBP decreased more than 20% of the basal value (group B). Record the use of norepinephrine, observe the occurrence of adverse reactions. Results Compared with group B, the SBP of group A was significantly higher than that of group B [(115 ± 12) mmHg vs. (95 ± 12) mmHg] at 7 min after anesthesia (P <0.05). There was no significant difference in heart rate between two groups Statistical significance (P> 0.05). The two groups of norepinephrine use rates were similar [38.5% (10/26) vs.36.0% (9/25)] (P> 0.05). A group of maternal dizziness, nausea, palpitation chest tightness adverse reaction rate was lower than the B group (P <0.01). Conclusion According to changes in heart rate in cesarean section prenatal noradrenergic timely and effective prevention of hypotension, thereby reducing the incidence of adverse reactions.