南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (12): 1806-.

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剖宫产全麻中丙泊酚中长链脂肪乳注射液的有效性及安全性

陈启忠,李志勤,姚向国   

  • 出版日期:2015-12-20 发布日期:2015-12-20

Clinical safety and effectiveness of propofol medium and long chain fat emulsion in
general anesthesia for cesarean section

  • Online:2015-12-20 Published:2015-12-20

摘要: 目的探讨丙泊酚中长链脂肪乳注射液应用于剖宫产术的安全性和有效性。方法回顾性分析我院于2014年1月~2015
年6月收治的88例行剖宫产手术的产妇临床资料,其中,对照组44例产妇采取硬膜外麻醉,而观察组44例产妇实施全身麻醉
(应用丙泊酚中长链注射液)。比较不同时间两组患者的MAP(平均动脉压)、SpO(2 血氧饱和度)、HR(心率)等指标;两组产妇及
新生儿相关指标;两组新生儿的脐动静脉血气分析各指标(pH、PO2、PCO2)。结果观察组在T2(手术切皮)的MAP、HR均升高,
组间差异具有统计学意义,其余时间两组的MAP、SpO2以及HR指标均基本相当,组间差异无统计学意义(P>0.05)。观察组的
手术切皮至新生儿娩出时间明显短于对照组,差异有统计学意义(P<0.05),而两组的子宫切开至新生儿娩出时间、阿普加评分
等均基本相当,组间差异无统计学意义(P>0.05)。两组新生儿的脐动静脉血气分析各指标(pH、PO2、PCO2)等均基本相当,组间
差异均无统计学意义。结论丙泊酚中长链脂肪乳注射液诱导全麻在剖宫产术中具有较大优势,其代谢快,产妇术后苏醒迅速,
且不会对胎儿产生明显的不良作用,值得临床应用。

Abstract: Objective To investigate the Clinical safety and effectiveness of propofol medium and long chain fat emulsion
injection for cesarean section. Methods A retrospective analysis was conducted in 88 cesarean section surgeries performed
between January, 2014 and June, 2015 with epidural anesthesia in 44 cases (control) and with total anesthesia with propofol/
long chain fat emulsion injection in 44 cases (observation group). The maternal mean arterial pressure (MAP), SpO2, and heart
rate and neonatal umbilical dynamic venous blood gas analysis (pH, PO2, pCO2) were compared between the two groups.
Results Compared with the control group, heart rate and MAP significantly increased at skin incision in the observation
group. At the other time points, heart rate, MAP, and SpO2 were all comparable between the two groups. The time from skin
incision to newborn delivery was significantly shorter in observation group (P<0.05), but the time from uterine incision to
delivery and neonatal Apgar score were equivalent between the two groups (P>0.05); neonatal umbilical arteriovenous blood
pH, PO2, and pCO2 were all comparable between the two groups. Conclusion Propofol medium and long chain fat emulsion
injection for general anesthesia induction in cesarean section is characterized by rapid metabolism of the anesthetics, rapid
maternal postoperative recovery, and minimal adverse effects on the fetus, and is therefore safe and reliable in clinical use.