| 引用本文： |
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陶怡怡,杜唯佳,李 江,等.不同剂量催产素对剖宫产产妇心排量及子宫张力影响的比较[J].同济大学学报（医学版）,2019,40(5):580-584. [点击复制]
- TAO Yi-yi,DU Wei-jia,LI Jiang,et al.Effects of oxytocin in different doses on cardiac hemodynamics and uterine tone during cesarean delivery[J].同济大学学报（医学版）,2019,40(5):580-584. [点击复制]
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| 摘要: |
| 目的 比较在剖宫产术中胎儿娩出后静注不同剂量的催产素对心输出量等血流动力学参数的影响，并评估子宫张力，以选择最优的催产素剂量。方法 选择腰硬联合麻醉下的择期剖宫产术产妇（n=160），随机分为4组，P1、P2、P3组（胎儿娩出后静脉注射1、2、3IU催产素）和P0组（注射生理盐水）。采用无创心排量监测仪（NICOM）观察心指数（cardiac index, CI）、每搏输出指数（stroke volume index, SVI）、心率（heart rate, HR）、血压（blood pressure, BP）、总外周血管阻力（total peripheral resistance, TPR）等血流动力学参数的改变，并记录产妇子宫张力评分、额外宫缩药物的使用、术中总出血量。结果 胎儿娩出推注试验药物后，4组产妇的HR、CI、SVI和BP等均无明显差异（P>0.05）；P3组BP、TPR用药后1.5min较其他3组明显降低（P<0.01）；P3组产妇的子宫张力评分明显高于其他3组，术中出血总量也明显减少（P<0.01）。结论 剖宫产术中胎儿娩出后静注3IU催产素，对产妇的血流动力学影响较小，但可达到满意的子宫张力，减少术中出血量和额外宫缩药物的使用。 |
| 关键词: 催产素 剖宫产 血流动力学 子宫张力 |
| DOI：10.16118/j.1008-0392.2019.05.009 |
| 投稿时间：2019-01-05 |
| 基金项目:上海市卫生健康委员会项目（201840149） |
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| Effects of oxytocin in different doses on cardiac hemodynamics and uterine tone during cesarean delivery |
| TAO Yi-yi,DU Wei-jia,LI Jiang,SONG Yu-jie,LIU Zhi-qiang,XU Zhen-dong |
| (Dept. of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China) |
| Abstract: |
| Objective To investigate the effect of oxytocin in different doses on cardiac hemodynamics and uterine tone during cesarean delivery. Methods One hundred and sixty pregnant women undergoing elective cesarean delivery with combined spinal-epidural anesthesia were randomly allocated to receive oxytocin of 1 IU（group P1）, 2 IU（group P2）， 3 IU（group P3） or normal saline（group P0） after delivery. NICOM was used to monitor hemodynamics including cardiac index（CI）, stroke volume index（SVI）, heart rate（HR）, blood pressure（BP）, total peripheral vascular resistance（TPR） continuously. Uterinetension score, additional uterotonic drugs and the estimated total blood loss were also recorded. Results There were no significant differences in HR, CI, SVI and BP immediately after injection of oxytocin among four groups. BP and TPR declined significantly at 1.5min after oxytocin administration in group P3 compared with those in other three groups（P<0.01）. The uterine tension score in group P3 was significantly higher than that in other three groups, and the estimated total blood lose in group P3 was significantly less than that in other three groups（P<0.01）. Conclusion During cesarean delivery, injection of 3 IU oxytocin immediately after fetus delivery can provide satisfactory uterine tone, reduce the additional uterotonic drugs and postpartum hemorrhage with mild effects on hemodynamics. |
| Key words: oxytocin cesarean delivery cardiac hemodynamics uterine tone |
